I authorize ProResults to analyze my sample(s) and provide the results to me and the ordering organizations and/or providers. I, furthermore, agree that my sample results can be sent to my email and/or texted to the phone number listed above, including any PHI associated with it. I understand and acknowledge that by checking this box I am legally agreeing to all of the statements in this form. *MANDATORY CDC-REQUIRED INFORMATION

 

If my test is being used for traveling: I understand it is my responsibility to check with my airline and travel destination regarding travel requirements, in order to ensure the test I have chosen fully complies with the latest guidelines.

 

I understand that I may be required to prepay for my test in order to confirm the appointment.  If prepayment is required ProResults will send you a payment request via email or text."