<p style="text-align: justify;">I understand and give my consent that test results reported by ANY LAB TEST NOW&reg; will be reported directly to me, in the manner I have chosen below. I understand that my test results will only be provided to other third parties upon my express consent. I further understand that it is my responsibility to consult my own medical doctor to interpretation, analysis, evaluation, and explanation of my test results. I understand that neither ANY LAB TEST NOW&reg; nor its ordering physician will analyze, evaluate, critique, review or otherwise interpret the results of said tests.</p>
<p style="text-align: justify;">I agree that ANY LAB TEST NOW&reg;, its officers, shareholders, directors, employed physicians, or its other agent or employee shall not be liable for any claims including, but not limited to, any claim arising out of or related to, inaccurate, un-interpreted, misinterpreted or results not received and do hereby expressly forever release and discharge all claims, demands, injuries, damage, actions or causes of action.</p>
<p style="text-align: justify;">I authorize ANY LAB TEST NOW to disclose my lab results, to the e-mail address I have indicated or/and an private online account. As stated in our Notice of Privacy Practice, I have the right to revoke or terminate this authorization by submitting a written request to the facility. This can be done in person or by mailing a request to the testing ANY LAB TEST NOW.</p>
<p style="text-align: justify;">I understand that ANY LAB TEST NOW has no control over who may have access to the e-mail address or online account I have listed to receive my lab results. The information disclosed will no longer be protected by the requirements of the Privacy Rule and future disclosers not responsibility of ANY LAB TEST NOW.</p>