I understand that the individual results of these screening tests will not be shared with my employer and will be used exclusively by Humana, in compliance with federal and state laws of health information management for their clinical and educational programs.
I understand that:
- This screening service is offered for my benefit and personal information and my participation is completely voluntary.
- The screening test(s) is not meant to replace the care of my personal physician.
- I acknowledge that I may receive results that may be considered “abnormal” as well as an explanation for these results. However, I also understand that screening tests can give false positive or negative results for a variety of reasons.
- I acknowledge that my physician is best able to interpret the results of these tests based on his/her understanding of my medical history.
I release and discharge Humana, its shareholders, officers, directors, employees and agents, and the owners/operators of this facility and its parent, subsidiaries, officers, directors and employees, from any and all claims or causes of action, on account of injury to me which may result from my participation in this screening (including a failure of the screening to detect any particular health problem). This release shall be binding upon my heirs, assigns, executors, administrators and representatives. I hereby consent to the administration of wellness screening tests.
I have read (or it has been read to me) and agree with all the terms and conditions listed above.
