COVID-19 Testing Consent Form
Informed Consent for COVID-19 Testing
Please carefully read the following informed consent:
I authorize this COVID-19 testing unit to conduct collection and testing for COVID-19 through anasopharyngeal swab, as ordered by an authorized medical provider or public health official.
I authorize my test results to be disclosed to the county, state, or to any other governmental entity asmay be required by law.
I acknowledge that a positive test result is an indication that I must continue to self-isolate in an effortto avoid infecting others.
I understand that I am not creating a patient relationship with Knox Public Health by participating intesting. I understand the testing unit is not acting as my medical provider. Testing does not replace treatment by my medical provider. I assume complete and full responsibility to take appropriate action with regards to my test results. I agree I will seek medical advice, care and treatment from my medical provider if I have questions or concerns, or if my condition worsens.
I understand that, as with any medical test, there is the potential for false positive or false negativetest results.
I, the undersigned, have been informed about the test purpose, procedures, possible benefits andrisks. I have been given the opportunity to ask questions before I sign, and I have been told that I can ask other questions at any time. I voluntarily agree to testing for COVID-19.