Consent for COVID-19 PCR Testing
All CLIA certified labs who process COVID testing must collect the demographic information of patient, i.e. Employee. The demographic information consists of DOB, Full Name, Home Address, Phone, Email, Race, and Ethnicity. The consent form is allowing the lab to share the test result with employer which is also cleared by EEOC (Equal Employment Opportunity Commission). Please refer to the article on EEOC website
https://www.eeoc.gov/wysk/what-you-should-know-about-covid-19-and-ada-rehabilitation-act-and-other-eeo-laws
A Typical Consent Form
"I consent to Inspire Diagnostics and subcontracted entities (“Company”) administering the test and collecting information from me as required for testing administration and by the Coronavirus Aid, Relief and Economic Security Act, including name, date of birth, address, gender, race, and ethnicity (“My Information”). My COVID-19 PCR test results and My Information will be disclosed to my employer,________ (“Employer”), pursuant to my written Authorization, only for the purposes of performing functions related to communicable disease prevention, control, and containment, including alerting others with whom I have come into contact of possible exposure to COVID-19, monitoring the workplace, and activities related to maintaining a safe work environment. I understand that COVID-19 PCR positive test results also will be disclosed to the applicable Public Health authorities and such Public Health authorities may contact me directly.
I understand that I am not entering into a doctor-patient relationship with Company. The potential risks of taking the COVID-19 PCR test include possible discomfort and other complications that can occur during specimen collection. I also understand the possibility of incorrect test results. Those who test positive will be notified and directed to see their health care provider for further evaluation.
I understand that I am entitled to receive a copy of this Consent once it has been signed and can request my COVID-19 PCR test results directly. If I have questions about the testing, its procedures, possible risks or benefits, the alternatives, or my rights, I can contact the Company."