HIPAA Acknowledgment

I acknowledge that Onsite Mobile Lab Services may collect, receive, and securely use my personal health information for scheduling, specimen collection, communication with my provider, and coordination with the appropriate laboratory.

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I authorize Onsite Mobile Lab Services to communicate with me by phone, text, email, or secure portal regarding my appointment, lab order, billing, and service-related needs.

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Financial Responsibility

I understand that Onsite Mobile Lab Services charges a mobile service/collection fee separate from any laboratory testing fees billed by Quest, Labcorp, specialty laboratories, or other testing companies.

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I understand that insurance may process laboratory testing fees separately, and Onsite Mobile Lab Services is not responsible for insurance coverage, claim denials, laboratory billing, or test result delays.

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Cancellation / No-Show Policy

I understand that once an appointment is confirmed, cancellation or rescheduling may require advance notice. Missed appointments, incorrect addresses, unavailable patients, or missing lab orders may result in a service fee.

Results Disclaimer

I understand that test results are released by the laboratory and/or ordering provider. Onsite Mobile Lab Services does not interpret results or provide medical advice.

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Consent
By signing below, I acknowledge that I have read and understand this agreement.