RELEASE OF LIABILITY

READ CAREFULLY – THIS AFFECTS YOUR LEGAL RIGHTS

In exchange for participation in the activity of services that may involve but not limited

to: Blood & Specimen Collections, organized by ZJO Enterprises, LLC dba LABS TO GO (“LABS TO GO”), of 5541 Parliament Drive Ste#203, Virginia Beach, VA 23462 and/ or use of the property, facilities and services of LABS TO GO.

I agree to the following:

  1. I recognize that there are certain inherent risks associated with the above described activity and I assume full responsibility for personal injury to myself and/or child and further release and discharge LABS TO GO or third-party testing lab for injury, loss or damage arising out of my use of or presence upon the facilities/services of LABS TO GO or third party vendor, whether caused by the fault of myself, LABS TO GO or other third party testing lab.
  2. I understand that there is no doctor and patient relationship between myself and Physicians, Employees, Representatives or Agents of LABS TO GO or third party testing lab. Services provided by LABS TO GO or third party testing lab are solely for the purpose required by myself or whom I have authorized.
  3. I understand that LABS TO GO send my specimens to a third-party accredited testing laboratory, therefore; no refund is given if my test results are taking longer than anticipated and is no fault of LABS TO GO or third party testing lab.
  4. Any minors under the age of 18 receiving services at any LABS TO GO facility or through third-party testing lab must be accompanied by an adult over 18 or a legal guardian that represents the minor and gives LABS TO GO and/or third-party testing lab authorization to provide services.
  5. Any legal or equitable claim that may arise from participation in the above shall be resolved under Virginia Law.

I HAVE READ THIS DOCUMENT AND FULLY UNDERSTAND. I FURTHER UNDERSTAND THAT BY SIGNING THIS RELEASE, I VOLUNTARILY SURRRENDER CERTAIN LEGAL RIGHTS AND THAT NO REFUNDS WILL BE GIVEN FOR TODAY’S SERVICES.

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