I authorize a Rapid Antigen COVID-19 Test. I further understand, agree, certify, and authorize the following: 1. The patient named above is consenting to the Rapid COVID-19 testing 2. I authorize Cedeno's Pharmacy, to release my results county, state, or to any other governmental entity as may be required by law. 3. This test has not been Food and Drug cleared or Administration (FDA) approved and has been authorized by FDA under an Emergency Use Authorization (EUA 4. I understand that this test does NOT rule out COVID-19 in ALL COVID-19 Patients. The possibility of a false negative result should be considered in the context of a recent exposures and the presence of clinical signs and symptoms consistent with COVID-19. If COVID-19 is still suspected based on exposure history together with other clinical findings, re-testing or testing
with molecular methods should be considered.
5. I understand this test is for COVID-19 screening purposes ONLY. This screening event is NOT for Medical or life-threatening medical emergencies. This screening event is NOT intended for diagnosis, treatment, recommendation and/or management of ANY medical conditions. This screening event is NOT a substitute for a regular Physician visit By signing below I acknowledge that I have read, understand, agree, certify, and/or authorize the information above and further agree to not hold Cedenos Pharmacy, its employees, agents, and contractors from any and all liability and claims. I, the undersigned, have been informed about the test purpose, procedures, possible benefits and risks, and I have received a copy of this Informed Consent. I have been given the opportunity to ask questions before I sign, and I have been told that I can ask additional questions at any time. I voluntarily agree to this testing for COVID-19.