Your company (“Company”) has partnered with Inspire Diagnostics to offer all employees the opportunity to receive COVID-19 testing on a voluntary basis.

By clicking below, I hereby acknowledge and agree:

1. I am voluntarily choosing to undergo COVID-19 testing administered by Inspire Diagnostics and I understand that I am not required to undergo such testing as a condition of employment.
2. Inspire Diagnostics will not share the results of my test with Company without my express consent, as set forth below. If I choose to share my test result with Company, I understand that Company will not use this result to make any decision about my employment status.
3. I understand and agree that this Authorization becomes effective when I complete this test registration process.
4. I understand that I may choose to (1) share my individual test result with Company OR (2) I may choose to share only de-identified aggregated results with Company (meaning that Company will receive the results of my test, but it will not know that the result came from me)

I hereby authorize Inspire Diagnostics to: (Please select one of the following three options)

•  Share my individual test results with Company.
•  Share my test result with Company on a de-identified and aggregated basis only.
•  I DO NOT authorize Inspire Diagnostics to share my test result with Company in any manner.

By clicking the CONSENT button below, I hereby consent to the terms of this authorization.