Consent for Hope Residence and High Island Creek Residence.
Filling out the below shall act as my signature and consent to participation of my dependent.
This waiver shall bind a minor participant if agreed to by that minor’s parent or legal guardian.
I AGREE TO BE TESTED. I UNDERSTAND THIS TESTING SITE WILL NOT FOLLOW-UP WITH MY PRIMARY CARE PHYSICIAN. I UNDERSTAND I WILL BE CONTACTED WITH THE RESULTS OF THIS TEST AND IF IT IS POSITIVE I WILL NEED TO FOLLOW-UP WITH MY PRIMARY CARE PHYSICIAN DIRECTLY. I UNDERSTAND THE PERSON WHO CALLS WITH MY RESULT IS AUTHORIZED ONLY TO COMMUNICATE MY RESULT AND SHARE GUIDANCE PROVIDED BY THE CENTERS FOR DISEASE CONTROL AND PREVENTION AND THE MINNESOTA DEPARTMENT OF HEALTH. THEY ARE NEITHER RESPONSIBLE OR LIABLE FOR ADDITIONAL FOLLOW-UP OR MY COURSE OF TREATMENT.