SCREENING FORM

The Participant, agrees that the test purchased by participant are for emergency use test purposes only and have not been approved, cleared or licensed for sale or use in the U.S. by the U.S. Food and Drug Administration (“FDA”). Emergency Use Authorization (“EUA”).
https://www.fda.gov/media/135659/download (collectively the “Policy”).
Collection and interpretation of the Tests shall only be performed by medical professionals. The Tests shall not be made available, sold, distributed or marketed, directly or indirectly, to the general public.
THE TESTS SHALL ONLY BE USED FOR PRELIMINARY SCREENING PURPOSES AND SHALL ONLY BE USED TO DETERMINE IF ADDITIONAL TESTING IS REQUIRED.
The Participant agrees to indemnify, defend and hold harmless Company and its officers, directors, shareholders, employees, agents, representatives, successors and assigns from any and all claims, demands, losses, liabilities, judgments, awards and costs (including attorney’s) fees arising out of or relating to the breach of this waiver by the Participant or any person affiliated with the Participant.

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If you would like a copy of this form sent to your email please fill out here, otherwise leave it blank.
Due to the limited number of tests if the results are inconclusive you will need to purchase another test if you wish to retest. We will offer a 50% discount for same day 2nd tests only.
Click or drag a file to this area to upload.