PICK LOCATION
LOCATION PICKED
PICK DATE
DATE PICKED
PICK TIME
TIME PICKED
PICK TEST
PICK TESTSELECTED TEST
Rapid RT-PCR(Results in less than 1 hr) | $250.00
(Tells if I have it currently)
RT-PCR(Results usually in 72 hrs) | $0.00
(Tells if I have it currently)
COVERED BY INSURANCE
RT-PCR(Results usually in 72 hrs) | $125.00
(Tells if I have it currently)
AntiBody(Results in 10-15 min) | $49.00
(Tells if I have the Antibodies that
come from having it in the past)
Antigen(Results in 10-15 min) | $100.00
(Tells if I have it currently, but most
accurate if I have symptoms)
Previous Tests
Previous Tests
Consent
Consent
I hereby voluntarily authorize the
disclosure of my protected health
information, including any and all test
results and vaccination records, provided by
GenTech Laboratories through MyDrSpace.com
and its subsidiaries, to:
- Me via email, even though email is not a completely secure means of communication.
- Me via SMS, even though SMS is not a completely secure means of communication.
- GenTech Laboratories and MyDrSpace.com
I also understand and agree to the
following:
- I may refuse to provide this authorization.
- I may revoke this authorization at any time in writing emailed to GenTech Laboratories and MyDrSpace.com at CONTACTUS@GENTECHDIAGNOSTICS.COM, except to the extent that action has been taken in reliance on this authorization.
- If this authorization has not been revoked, it will terminate one year from the date of effectiveness below.
- I have a right to request and receive a copy of this authorization.
- Any information disclosed pursuant to this authorization may be subject to redisclosure by the recipient, and any redisclosure may not be subject to HIPAA.
- This authorization is effective immediately upon clicking the button “Agree and continue” on this authorization page.