TEST2FLY – COVID-19 Testing

Test2FLY monitors 197 countries, the United States, and territories utilizing over 1000 testing facilities nationwide managing all travel requirements for stress-free travel.

Do You Need A COVID-19 Test To Travel, Fly Domestic Or International?

*information provided is for non-essential travel. Traveling for essential purposes please contact Test2FLY directly for assistance.

Travelling to *

State *

Are you a U.S. Citizen? *

No Entry *

U.S. CITIZENS ARE NOT ALLOWED ENTRY

U.S. Citizens are allowed entry *

U.S. Citizens are allowed entry

COVID-19 Testing Required *

COVID-19 Testing Required

No COVID-19 Test Required

No COVID-19 Testing Required

No Covid Testing is required at this time.

Please provide us with your contact information so we can keep you up-to-date on the latest COVID-19 travel requirements.

U.S. Citizens are not allowed entry at this time.

Please provide us with your contact information so we can keep you up-to-date on the latest COVID-19 travel requirements.

Name *

First

Last

Email *

Phone

Number of Tests *

Urgent same day test, for result in less than 24 hours submit information below and call 1-800-940-9153

Yes, I am in urgent need of my test results!

Full Name on Passport (Test #1) *

First

Middle

Last

Date of Birth *//

Email *

Confirm Email

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone *

Gender *

*Race and ethnicity are collected to comply with the Secretary of the Department of Health and Human Services (HHS) reporting requirements.

Ethnicity *

Race *

Full Name on Passport (Test #2) *

First

Middle

Last

Date of Birth *//

Email *

Gender *

Ethnicity *

Race *

Full Name on Passport (Test #3) *

First

Middle

Last

Date of Birth *//

Email *

Gender *

Ethnicity *

Race *

Full Name on Passport (Test #4) *

First

Middle

Last

Date of Birth *//

Email *

Gender *

Ethnicity *

Race *

Full Name on Passport (Test #5) *

First

Middle

Last

Date of Birth *//

Email *

Gender *

Ethnicity *

Race *

Full Name on Passport (Test #6) *

First

Middle

Last

Date of Birth *//

Email *

Gender *

Ethnicity *

Race *

Full Name on Passport (Test #7) *

First

Middle

Last

Date of Birth *//

Email *

Gender *

Ethnicity *

Race *

Full Name on Passport (Test #8) *

First

Middle

Last

Date of Birth *//

Email *

Gender *

Ethnicity *

Race *

Full Name on Passport (Test #9) *

First

Middle

Last

Date of Birth *//

Email *

Gender *

Ethnicity *

Race *

Full Name on Passport (Test #10) *

First

Middle

Last

Date of Birth *//

Email *

Gender *

Ethnicity *

Race *

Additional Test Details *

Flight already booked? *

Yes
No
Flight not required for my travel

Departure Date *//

To ensure testing complies with entry requirements we need to match test time to flight time.

Departure Time *

Departure City *

Airline/Flight # *

Final Destination *

Our Covid Travel Concierge service is included with all tests, monitors flights for cancellations and changes. T2F matches the authorized Covid-19 test for the specific destination, creates the appointment in test window as required by destination and reviews test documentation for accuracy. We monitor every country in the world for Covid-19 test changes. We are available 24/7/365, provide rebooking flight assistance and reschedule testing appointments to ensure that the test window matches new air travel for NO EXTRA FEE. Our Covid Travel Concierge provides everything for non-quarantine stress-free travel.

INCLUDED

Book your test and flight together with peace of mind with the Covid Travel Concierge service.

Yes, I'd like to book my test and flight together.
No, Thank you, I will make my own travel plans.

Departure *

Departure Date / Time *//

Return Date / Time *//

Cabin Class *

First Class
Business Class
Economy Class

Additional Travel Details

TERMS AND CONDITIONS

Test2Fly, LLC MEMBER TERMS & CONDITIONS

The services of Test2Fly (the “Services”) are offered to you, conditioned on your acceptance without reservation, or modification of the following terms, conditions, and notices contained in this agreement (the “Terms and Conditions”). Your use of the Test2Fly, LLC Website or mobile apps, or submission of “Service Requests” via telephone constitutes your agreement to all such terms, conditions, and notices in effect at such time. These Terms and Conditions apply to any Services or properties such as websites or apps owned and operated by Test2FLY, LLC (including but not limited to Test2FLY.org, the Test2FLY website and mobile apps, etc.) and collectively referred to herein as “Test2FLY,” on which a link to these Terms & Conditions appears. If you have any questions regarding these Terms & Conditions, you may contact us at Info@Test2FLY.com. We may amend these Terms & Conditions at any time by posting a revised version of these Terms and Conditions. These Terms & Conditions were last updated on November 23, 2020.

These Terms & Conditions (herein “Agreement”) governs your relationship with the Company. In this Agreement, we will refer to you, the “User,” and all of your agents and representatives, interchangeably as “you” or “Customer” or “Client,” and to Test2FLY, LLC and its employees and agents as “we” or “us” or “Test2FLY” or “Company.” We will refer to the third-party companies and all of their agents and representatives, interchangeably as “Vendors”, “Service Providers”, “Service Providers”, or “SPs. References herein to the Test2FLY website include any and all websites and mobile apps now, or hereafter, owned or operated by Test2FLY LLC.

Any headings or formatting below are purely for organizational purposes and not to imply or demonstrate any additional meaning therefrom.

1. INTRODUCTION TO Test2Fly
Upon submitting the necessary information (and as instructed) on the Website, Test2FLY will contact you with further instructions for how to proceed and what to expect in planning the Services (as described further in Section 2, below) you have selected.

2. THE SERVICES.
The below are the express Services offered by Test2FLY to customers and are subject to change and additional fees upon reasonable notice to Customer.

a. Scope of Services. Test2FLY offers assistance in connecting with a multitude of Service Providers. Upon receiving the necessary documentation, as described by Test2FLY, as well as Customer’s specification of which services it wishes to pursue via this Agreement, Test2Fly will arrange for those services to be imparted to Customer. A non-exhaustive list of the Services provided by Test2FLY include:

i. Covid-19 Testing. Based on your needs Test2Fly will identify the medical testing facility nearest to Customer’s vicinity that maintains the correct and compliant test needed for your scenario. Test2FLY will assist in delivery of those results to you once they are provided by the relevant Service Provider.

ii. Transportation. Test2FLY also provides transportation advisement and arrangement as optional Services. At any time Customer may express its desire for these Services and Test2Fly will make reasonable efforts to arrange the same.

iii. Lodging. Test2FLY provides lodging and accommodation advisement and arrangement as optional Services. At any time Customer may express its desire for these Services and Test2FLY will make reasonable efforts to arrange the same.

iv .Visa. Test2FLY does not provide Visa procurement services, though at Customer’s request may make recommendations of such third parties that may be able to assist.

v. Misc. Test2FLY may offer additional services, at its sole discretion, and at potential additional costs to Customer on a case by case basis.

NOTE: Test2FLY cannot and does not guarantee either that a certain result will be attained or as to the quality, competency, certification or other legal compliance of any Service Provider. And therefore will not be responsible for the harm caused therefrom for engaging with said Service Provider, whether directly or indirectly. Any such rights to such claims is hereby, waived by the Customer. This includes cost relating to delayed or missed flights, events, experiences and the like.

Terms and Conditions 1 *

I have read and agree to the statements above

b. Booking. Customers shall submit their travel itinerary (where to, when, and how they plan to travel) – along with whether they wish for Test2FLY to book travel or lodging arrangements – and Test2FLYwill propose options for consideration by Customer. Once Customer has chosen a plan, Customer will remit payment to Test2Fly and Test2Fly will implement the same.

c. 3rd Party Offers. Test2FLY cannot validate, substantiate or otherwise recognize or guarantee offers made by Service Providers. Indeed, any such offers made shall be understood by Customer that such offers do not constitute a contract or representation by Test2FLY in any way whatsoever. Test2FLY will act on Customer’s behalf to construct agreements with regard to all Services, to Customer’s benefit.

d. Limitations of Liability. Customer understands, agrees to and consents to waive any and all claims to the extent capable by law against Test2FLY with regard to any dispute with respect to any service provided by any Service Provider engaged via Test2FLY’s Services. Any such dispute and remedy to resolve the same shall be addressed by the Service Provider directly (although you may notify Test2Fly of the dispute).

YOU HEREBY AGREE TO RELEASE TEST2FLY (AND OUR OFFICERS, DIRECTORS, SHAREHOLDERS, AFFILIATES, EMPLOYEES AND AGENTS) FROM ANY DAMAGES OR CLAIMS (INCLUDING CONSEQUENTIAL AND INCIDENTAL DAMAGES) OF EVERY KIND OR NATURE, SUSPECTED AND UNSUSPECTED, KNOWN AND UNKNOWN, AND DISCLOSED OR UNDISCLOSED, ARISING OUT OF OR IN ANY WAY CONNECTED WITH SUCH DISPUTES AND YOUR DEALINGS WITH SERVICE PROVIDERS.

Terms and Conditions 2 *

I have read and agree to the statements above

3. YOUR USE OF TEST2FLY SERVICES AND PROHIBITED USES

a. Usage. You acknowledge and agree that your use of Test2Fly is for your personal use, or accepted and disclosed business purposes and not for advertising purposes. You may not use Test2Fly to recreate or compete with Test2Fly, to solicit or harass Service Providers, or for any other purpose not expressly contemplated herein.

b. Penalty. You acknowledge that a violation of the foregoing could result in significant damages, and you agree that you are liable to Test2Fly for any such damages, and will indemnify Test2Fly in the event of any claims against Test2Fly based on or arising from your violation of the foregoing.

c. Access. We reserve the right to revoke your access to any Test2Fly Services, products or properties at any time. All information about Service Providers is confidential and for your personal or expressly approved use only.

d. Misc. If it is determined or suspected by Test2Fly, in its sole discretion, that you are misusing or attempting to misuse or circumvent the Test2Fly services or system, or are using or attempting to use them for any inappropriate or non-personal purposes, including but not limited to activities such as hacking, scraping content, infiltrating, fraud, advertising, jamming or spamming, Test2Fly reserves the right, in its sole discretion, to immediately terminate your access without notice and to initiate without notice appropriate legal actions or proceedings to seek appropriate remedies and/or damages, including but not limited to lost revenue, repairs, legal fees, costs and expenses, and to seek injunctions or other equitable remedies.

4. PAYMENTS

a. General. As referenced above, payment for any and all Services will be transmitted to Test2Fly to arrange the relevant Services. Test2Fly to may utilize certain payment processing services to receive and execute the transaction with the consent of Customer. Test2Fly does not retain payment or financial information for longer than is reasonably necessary to comport and comply with applicable law and regulation.

b. Timing. Payment is required and shall be made via PayPal and pursuant to the invoice provided to Customer by email. If there is any difficulty receiving said invoice contact Info@Test2Fly.com. Payment shall be made upon receipt of the invoice and prior to Services being rendered. All alternative agreements, if any, regarding payment will be stipulated in writing on the applicable invoice.

c. Failure to Pay. Failure to pay, even if the result of a declined card or electronic transaction, or an insufficient financial instrument may result, at the sole discretion of Test2Fly, in the immediate suspension or termination of the Services. Test2Fly may charge, and Customer agrees to pay any fees or financial penalties associated with failed transaction as a result of incorrect information provided or defective payment instructions given to Test2Fly.

d. Refunds. All sales and transactions related to the Services are final and subject to the following provisions:

i. CANCELLATION. In the event Customer cancels a medical test, Customer shall be entitled to a full refund minus $35.00 USD. Any other fees deducted related to medical examinations must be notified by Test2Fly ahead of such charges being incurred.In the event of cancellation of any other Service by Customer, Test2Fly will advise Customer of the cost of cancellation prior to the confirmation of cancellation by Customer and Customer agrees that Test2Fly may hold Customer responsible for any reasonable fees that Test2Fly has incurred as a result of cancellation;

ii. CHANGES TO TRAVEL. In the event Customer’s travel plans change and payment has already occurred the following terms shall apply:If Customer is prevented from traveling to their desired destination because of a governmental or legal travel restriction (that is of no fault of the Customer), then Customer shall be entitled to:

A full-credit for any monies paid to Test2Fly, OR a refund less $35.00, if Customer has not yet received Services from Test2Fly (Eg. has not yet taken a Covid-19 test).
Credit or limited refund (including no refund) for an additional test if the entry requirements have changed after payment to Test2Fly and a medical test has been completed, at Test2Fly’s sole discretion; and
Refund of ($35.00) if Customer is quarantined upon arrival at the desired destination. In order to qualify for said refund, Customer must provide a certified or verifiable document from the relevant governmental authority requiring said quarantine.
No refund, if Customer as already received Services from Test2Fly (Eg. has already taken a Covid-19 test).

Terms and Conditions 3 *

I have read and agree to the statements above

5. PERSONAL INFORMATION & DATA PROTECTION

a. Generally. Upon engaging Test2Fly, you will be prompted to disclose certain information about yourself and your Service requirements. Some of this information will be sent to Service Providers who will need this information to respond to your request. By way of this Agreement, you expressly state, consent and otherwise agree for Test2Fly to collect and store this information as necessary to complete the Services and to transmit to third parties, including Service Providers (who will use the information in a similar fashion, but potentially for their own purposes unless expressly advised not to) with respect to the same. You also understand that you have the right to require Test2Fly to dispose of this information at any time and that Test2Fly will comply.

You also understand that if you are a person to whom the European Union’s General Data Protection Regulation Applies that you will advise Test2Fly immediately.

Customer consents to receive communications from Test2Fly about the Services, and future potential services via text (SMS) messaging, phone, fax, email, mail or other reasonable means at the contact information that Customer provides. This information will continue to arrive unless expressly requested to cease by Customer. You acknowledge that you have read and understand the implications of this section in particular in relation to Test2Fly’s Privacy Policy.

Terms and Conditions 4 *

I have read and agree to the statements above

b. Relationship of the Parties. Customer agrees that by completing a service request, Customer is entering a business relationship with Test2Fly and by extension the Service Provider and thus agree to be contacted by Test2Fly and/or Service Provider. You promise that all information that you provide (including but not limited to your contact information, and any Ratings and Reviews of Service Provides that you provide) will be accurate, current and truthful to the best of your knowledge. Violation of this term may result in Test2Fly terminating or suspending future service.

You are responsible for any use of the Test2Fly’s Services by persons whom you intentionally or negligently authorize to act on your behalf.

TO KNOWINGLY INPUT FALSE INFORMATION, INCLUDING BUT NOT LIMITED TO NAME, PHONE NUMBER, ADDRESS OR E-MAIL ADDRESS IS A VERY SERIOUS AND FRAUDULENT MATTER THAT COULD RESULT IN SIGNIFICANT COSTS AND DAMAGES INCLUDING INVASION OF PRIVACY RIGHTS, TO TEST2FLY AND THE SERVICE PROVIDERS, AND TO CONSUMERS, AS WELL AS THE LOSS OF TIME, EFFORT AND EXPENSE RESPONDING TO AND PURSUING SUCH FALSE INFORMATION AND REQUEST, AND FURTHER, COULD RESULT IN REGULATORY FINES AND PENALTIES. ACCORDINGLY, IF YOU KNOWINGLY INPUT FALSE INFORMATION IN A SERVICE REQUEST, INCLUDING BUT NOT LIMITED TO SOME ONE ELSE’S NAME, E-MAIL ADDRESS, PHYSICAL ADDRESS OR PHONE NUMBER OR A RANDOM OR MADE UP NAME, ADDRESS, E-MAIL OR PHONE NUMBER YOU AGREE TO FULLY INDEMNIFY AND BE LIABLE TO TEST2FLY AND EACH SERVICE PROVIDER WHO ACCEPTS SUCH SERVICE REQUESTS, FOR THE GREATER OF: (1) A MINIMUM AMOUNT OF $11,000 TO EACH OF TEST2FLY AND EACH OF THE AFFECTED SERVICE PROVIDERS AND FOR EACH OF THE ACTUAL PERSON(S) AFFECTED BY ANY OF THE IMPROPER, INCORRECT OR FRAUDULENT INFORMATION YOU ENTER (FOR EXAMPLE THE ACTUAL OWNER OF THE E-MAIL ADDRESS OR PHONE NUMBER, ETC.), PER IMPROPER SUBMISSION, PLUS ANY ATTORNEYS FEES COSTS AND EXPENSE RELATING THERETO, IF APPLICABLE, OR (2) THE ACTUAL DAMAGES, DIRECT, PUNITIVE AND CONSEQUENTIAL, AND ANY REGULATORY OR JUDICIAL FINES OR PENALTIES THAT MAY ARISE FROM SUCH INTENTIONAL, MISLEADING, HARMFUL AND FRAUDULENT ACTIVITY, PLUS REASONABLE LEGAL FEES, COST AND EXPENSES RELATING THERETO, WHICH EVER IS GREATER.

c. Call Recording. You acknowledge and agree that Test2Fly may monitor and/or record any telephone calls between you and Test2Fly.

6. RATINGS & REVIEWS ARE NOT ENDORSED BY TEST2FLY.

All ratings and reviews of a Service Provider displayed to you reflect the opinions of other consumers, and do not reflect or represent the opinions or representation of Test2Fly. Test2Fly disclaims any and all representations or warranties with regard to the ratings and reviews. Test2Fly does not assume responsibility or liability for any reviews, claims, damages or losses resulting from any use of the Test2Fly Website, apps or materials contained therein.

ADVICE PROVIDED.

Test2Fly may provide certain content relating to travel, Covid-19 impacts, transportation, lodging or other topics – this content shall not be construed, in any way whatsoever, as professional advice within any context, meaning (implied or otherwise) of the term and shall not be relied upon as such. Customer agrees and acknowledges the fact that Test2Fly’s comments do not constitute as advice nor do they substitute for the need to seek a credentialed professional, as applicable.

Terms and Conditions 5 *

I have read and agree to the statements above

8. LINK TO THIRD PARTY SITES.

Links on the Test2Fly Website or applications may allow you to leave the Test2Fly Website, however, such sites are not under the control of Test2Fly and Test2Fly does not accept any liability for the usage of such third party sites.

9. THIRD PARTY COPYRIGHTS AND OTHER RIGHTS

Test2Fly respects the intellectual property rights of others. If you believe that your copyright has been infringed, please send us a notice as Info@Test2Fly.com].

10. INDEMNIFICATION.

YOU AGREE TO INDEMNIFY TEST2FLY, AND ITS SUBSIDIARIES, AFFILIATES, OFFICERS, EMPLOYEES, AGENTS, CO-BRANDERS, AND ANY PARTNERS AND HOLD THEM EACH HARMLESS FROM ANY AND ALL CLAIMS OR DEMANDS, INCLUDING ATTORNEY’S FEES, MADE BY ANY THIRD PARTY DUE TO OR ARISING FROM YOUR USE OF THE TEST2FLY SERVICES GENERALLY, AND IN CONNECTION WITH THE TEST2FLY WEB SITE, WITH REGARD TO ANY DISPUTE BETWEEN YOU AND A SERVICE PROVIDER, OR YOUR VIOLATION OF THESE TERMS AND CONDITIONS, OR ARISING FROM YOUR VIOLATION OF ANY RIGHTS OF A THIRD PARTY.

11. GOVERNING LAW & DISPUTE RESOLUTION

a. Governing Law. These Terms and Conditions, and any dispute between you and Test2Fly, shall be governed by the laws of the state of Florida without regard to principles of conflicts of law, provided that this arbitration agreement shall be governed by the Federal Arbitration Act.

b. Dispute Resolution. The exclusive means of resolving any dispute between Customer and Test2Fly related to the Services or any claim made by Customer or Test2Fly arising out of or relating to your use of this Website (including any alleged breach of these Terms & Conditions) shall be binding and confidential arbitration administered by the American Arbitration Association. The seat of the arbitration shall be Miami, Florida and the language of the arbitration shall be English. Test2Fly, in its sole discretion, shall decide whether one or three arbitrators is appropriate for the given dispute.

Nothing in these Terms & Conditions shall be construed to imply that the parties may not negotiate or consider other mean of dispute resolution, such as mediation or conciliation.

NOTICE: BY CONTINUING TO USE THIS WEBSITE AFTER RECEIVING THIS NOTICE, OR ACCEPTING THE SERVICES FROM TEST2FLY, CUSTOMER WAIVS THEIR RIGHT TO PURSUE REMEDY FROM COURTS OR ANY OTHER DECISION MAKING AUTHORITY WITH JURISDICTION OVER THE PARTIES. NAMELY, IN THE CASE OF A DISPUTE THE BINDING DECISION WILL BE MADE BY AN ARBITRATOR RATHER THAN BY A COURT. DECISIONS BY THE ARBITRATOR ARE ENFORCEABLE IN COURT ANND MAY BE OVERTURNED BY A COURT FOR SPECIFIED REASONS ONLY.

In the event this dispute resolution provision is found to be invalid, the parties shall submit any disputes to the state or federal courts located in Miami, Dade County, Florida. for further adjudication.

Terms and Conditions 6 *

I have read and agree to the statements above

12. GENERAL PROVISIONS.

a. Final Waiver. Customer acknowledges that the Services are provide to you on an “As Is” basis without any warranty whatsoever, and your sole end exclusive remedy, and Test2Fly’s sole obligation to you or any third party for any claim arising out of your use of Test2Fly Services or its Website, is that you are free to discontinue your use of Test2Fly’s Service, or Website at any time.
For the removal of all doubt, EXCEPT FOR AS EXPRESSLY SET FORTH HEREIN, TEST2FLY EXPRESSLY DISCLAIMS ANY IMPLIRED WARRANTIES OF ANY KIND, INCLUDING, BUT NOT LIMITED TO, WARRANTIES OF MERCHATABILITY OR FITNESS FOR A PARTICULAR PURPOSE AND YOU AGREE THAT TEST2FLY SHALL HAVE NO LIABILITY FOR DIRECT, INDIRECT, SPECIAL, INCIDENTAL, CONSEQUENTAL (INCLUDING LOST PROFIT, OPPORTUNITY, ENJOYMENT OR EXPERIENCE) WHICH FLOW FROM IT. SOME STATES AND PROVINCES DO NOT ALLOW LIMITATIONS ON OR EXCLUSION OF INCIDENTAL OR CONSEQUENTIAL DAMAGES. TO THE EXTENT THOE LAW OF THOSE STATE’S APPLY, CUSTOMER EXPRESSLY WAIVES THE RIGHT TO CLAIMS TO THE FULLEST EXTENT POSSIBLE UNDER THE LAW.The Terms and Conditions will inure to the benefit of Test2Fly’s successors, assigns and licensees.

b. Severability. If any provision of these Terms and Conditions shall be deemed unlawful, void or unenforceable, for any reason, by any court of competent jurisdiction that provision shall be modified in order to make it enforceable, if modification is not possible, such provision shall be stricken and shall not affect the validity and enforceability of the remaining terms. The failure of Test2Fly to exercise or enforce any right or provision of the Terms and Conditions shall not constitute a waiver of such right or provision. Customer agrees that regardless of any statute or law to the contrary, any claim or cause of action arising out of or related to use of the Services, must be filed within one (1) year after such claim or cause of action arose or be forever barred.

c. Entire Agreement. These Terms and Conditions constitute the entire agreement between you and Test2Fly and supersedes all oral and written negotiations or representations of the parties with respect to the subject matter hereof. These Terms and Conditions may not be modified or amened other than express written agreement signed by both parties.

HIPPA WAIVER

COVID-19 Testing Consent and HIPAA Data Use Authorization & Waiver

The Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) law allows for the use of protected health information (“PHI”) for the treatment, payment, or provision of healthcare operations or services related thereto. (Full text available, here.) You have the right to restrict how your PHI is used and disclosed for treatment, payment, healthcare operations or for immigration & travel purposes.

This waiver & release is strictly related to only those certain services (“Services”) purchased by me fromTest2Fly and further described in the Terms & Conditions.
I authorize the use of my oropharyngeal / nasopharyngeal / mid-turbinate swab and / or saliva specimen for COVID-19 Testing. I further understand, agree, certify, and authorize the following:
The collection, analysis, and transmission (both physically and digitally) of my information to the necessary parties to process and otherwise complete the Services with Test2Fly.
The organization and/or synthesis of my information into a format or manner acceptable in completing the Services.
Discussion of my PHI by Test2Fly with other parties in order to complete the Services, only.
Test2Fly may use an anonymized version of my PHI for its internal and external business purposes.
Test2Fly may reasonably amend information that appears to be an error of cleric or incident that appears to be misleading or inaccurate.
The communication of my PHI to the relevant US and non-US governmental entities in connection with the Services.
Waiver of any and all claims otherwise provided via HIPAA relating to my PHI to the extent permissible by applicable law.
Disclosure of my PHI to Test2Fly may be re-disclosed and such disclosure may not be covered by state or federal law.
Maintain my PHI for as long as reasonably necessary for Test2Fly’s operations.
My PHI to provided as required by applicable regulation or law both in the US or by foreign States.

NOTE: I understand that the test results may provide information that could impact my own and other family members’ health, including the risk of developing a particular condition.

HIPAA 1 *

I have read and agree to the statements above

My Rights:
I have a right to:Know, upon my request; i) what specific PHI of mine has been disclosed, ii) what 3rd Parties, if any, it has been disclosed to, andiii) why this information has been disclosed; Revoke this agreement at any time and Test2Fly must delete my information within a reasonable time of said revocation; To be notified, immediately, if my PHI is exposed to unapproved parties whether intentionally or unintentionally, and in particular in the case of a data breach; and Request a reasonable explanation of the efforts and procedures implemented by Test2Fly to protect my PHI.
For the removal of all doubt
THIS EXECUTION OF THIS DOCUMENT AUTHORIZES Test2Fly TO DISCUSS AND DISCLOSE MY PHI AS REASONABLY NECESSARY AND TO THE EXTENT PERMITTED BY LAW WITH PARTIES NECESSARY IN PROVIDING SERVICES FOR AND TO ME. THIS MAY INCLUDE (BUT IS NOT LIMITED TO); Eg. AIRLINES, CRUISE SHIPS, TRAVEL AGENCIES, GOVERNMENTAL DEPARTMENTS OUTSIDE OF THE UNITED STATES SUCH AS HEALTH DEPARTMENTS, CUSTOMS ENFORCEMENT, IMMIGRATION AND SIMILAR ORGANIZATIONS OR PARTIES AS INSTRUCTED BY ME. UPON REQUEST, Test2Fly WILL FURNISH A LIST OF RECIPIENT OF MY PHI IN A REASONABLE AMOUNT OF TIME IN ACCORDANCE WITH APPLICABLE LAW AND REGULATION.

HIPAA2 *

By clicking/checking this box, I acknowledge, affirm and attest that I understand the above stated and have been fully informed of my rights under HIPAA—if not by this document, then by my own competence. I have had the chance to confer with counsel, if so desired, and agree to the above stated.

HIPAA 3 *

By clicking/checking this box, I attest that I am the age of 18 or older and have full capacity to make decisions with regard to my PHI.

HIPAA 4

If client is under the age of 18. By clicking/checking this box, I attest that I do so as the parent, or authorized legal guardian with the ability, capacity and the consent of the above signed. [Name of Your Company] cannot and will not be held liable for any misrepresentation regarding this provision.

Signature

Signature *

First

Last

Sign and Agree *

By Adding your name and clicking this box you agree to the Terms & Conditions/HIPAA Waiver

Signature (Test #2) *

First

Last

Sign and Agree *

By Adding your name and clicking this box you agree to the Terms & Conditions/HIPAA Waiver

Signature (Test #3) *

First

Last

Sign and Agree *

By Adding your name and clicking this box you agree to the Terms & Conditions/HIPAA Waiver

Signature (Test #4) *

First

Last

Sign and Agree *

By Adding your name and clicking this box you agree to the Terms & Conditions/HIPAA Waiver

Signature (Test #5) *

First

Last

Sign and Agree *

By Adding your name and clicking this box you agree to the Terms & Conditions/HIPAA Waiver

Signature (Test #6) *

First

Last

Sign and Agree *

By Adding your name and clicking this box you agree to the Terms & Conditions/HIPAA Waiver

Signature (Test #7) *

First

Last

Sign and Agree *

By Adding your name and clicking this box you agree to the Terms & Conditions/HIPAA Waiver

Signature (Test #8) *

First

Last

Sign and Agree *

By Adding your name and clicking this box you agree to the Terms & Conditions/HIPAA Waiver

Signature (Test #9) *

First

Last

Sign and Agree *

By Adding your name and clicking this box you agree to the Terms & Conditions/HIPAA Waiver

Signature (Test #10) *

First

Last

Sign and Agree *

By Adding your name and clicking this box you agree to the Terms & Conditions/HIPAA Waiver

Sign and Agree *

I agree to recieve product information and offers from Test2FLY