The following are the conditions
of Informed Consent that I have read.
I acknowledge that I understand these
conditions and I agree to all of these conditions voluntarily.
I acknowledge
my agreement to these conditions by accepting these conditions as a condition
of purchasing a DirectDx diagnostic test kit and by submitting a sample for
testing and by using my personal identifier number to access test results.
I authorize DirectDx to use an
authorized laboratory to test the specimens for the presence of Chlamydia.
I understand that a negative test result means that Chlamydia was not detected
by the test.
I understand that inaccurate results may occur and that a negative test may
occur when I am actually infected.
I understand that a positive result means that I should consider myself
infected with Chlamydia and I should take appropriate actions to prevent
infecting others including informing sex partners.
I understand that an indeterminate result means that the test result is
neither negative or positive and I should be tested again.
I understand that although the test is confidential and that no one other than
those directly involved in the testing and health officials authorized by law
will have access to my test results.
I understand that the name and address to
which the test kit was sent may be given to the health department if the test
result is positive.
I understand that DirectDx assumes no responsibility for injury that may occur
if the test kit is used in any manner than described in the kit instructions.
I understand that DirectDx assumes no responsibility to provide medical care
regardless of the test result.
I understand that my test result will be identified only by the coded number
provided with the test kit to protect my identity.
I understand that failure to strictly adhere to all test kit instructions may
result in inaccurate test results or my specimen not being tested.
I agree that the liability of DirectDx shall be limited to the purchase price
of this specimen collection kit.
