Antigen Test Service Agreement
1- Acceptance of General Terms and Conditions
By signing this service agreement, I acknowledge and confirm that I agree to Flamingo Pharmacy’s General Terms & Conditions and I accept the applicability thereof to my agreement and relationship with Flamingo Pharmacy.
2- Interpretation
All terms defined in Flamingo Pharmacy’s General Terms & Conditions have the same meaning when used in this service agreement.
3- General consent for antigen screening/testing
I understand that Flamingo Pharmacy requires consent of the client and may require the consent of a parent or guardian, for the provision of screening/testing services in respect of the client. By signing this form, I consent to the provision of screening/testing services by or on behalf of Flamingo Pharmacy. I understand that a medical record may be prepared and maintained about me by Flamingo Pharmacy.
4- Screening/testing services
Flamingo Pharmacy will provide screening/testing services in compliance with its authority with the Government of the Turks and Caicos Islands. This is a lateral flow antigen test. It is not a PCR test. Certification is delivered within 24 hours via email or pick up a printed copy. No warranty, expressed or implied, is made or intended by providing screening/testing services or by furnishing results or reports of the findings made. Flamingo Pharmacy will under no circumstances be liable to the client for any direct, indirect or consequential damage suffered by client in any way arising from or in connection with the screening/testing service or client’s use of the test results.
5- Limitations
Flamingo Pharmacy follows the manufacturer’s guidelines and instructions for use which are available to clients on request. Results from antigen screening/testing should not be used as the sole basis to diagnose or exclude SARS-CoV-2 infection or to determine infection status. Negative results, should be treated as presumptive only. The prevalence of infection will affect the test’s predictive values. Positive and negative predictive values are highly dependent on prevalence. False-negative test results are more likely during peak activity when the prevalence of the disease is high. False-positive test results are more likely during the periods of low SARS-CoV-2 activity when prevalence is moderate to low.
6- Consent to additional services, reimbursements, information sharing and communication via email
In the event of an initial positive result, I agree to conduct a 2nd screen/test at my expense. In the event of a positive result, I agree to isolate myself and any exposed family members in my place of residence. In the event of a 2nd positive result, I agree that Flamingo Pharmacy will inform the Ministry of Health for further investigation. I agree to the collection and sharing of information for the purposes of scheduling, notification, billing and follow up by Flamingo Pharmacy. I understand that Flamingo Pharmacy must share my personal/health information related to the screening/testing with the Ministry of Health. By agreeing to these terms, I consent to communication via non-secure electronic means, specifically by email to the email address I have provided.
Insurance:
I have Private Health Care insurance and agree that The Company and/or its affiliates can bill my insurance for costs related to the tests.
I hereby authorize Flamingo Pharmacy and its affiliates to submit my COVID-19 Test procedure to my health insurance company on my behalf. I hereby assign Flamingo Pharmacy as my assigned beneficiary to receive payment(s) from my health insurance company for this test procedure, so that Varsity Health my pay the healthcare provider for my COVID—19 test. I hereby hold harmless and indemnify Flamingo Pharmacy from all liabilities, damages, losses and costs (including any attorney fees) associated with the claim filings associated with my COVID-19 test. This assignment may be rescinded by providing a written letter to Flamingo Pharmacy by certified mail at least 14 days following the commencement date of this document.
OR
I do not have insurance and agree that The Company and/or their affiliates can bill the COVID-19 Uninsured Program.
7- Acceptance of service agreement
This service agreement will be regarded as governing the relationship between Flamingo Pharmacy and the client even if it is not signed and even when “Book Now” is selected when making an online booking.