Above Health – Lab Testing Consent and Payment Agreement

Effective Date: August 13, 2025

This Lab Testing Consent Form ("Consent") governs your purchase and use of laboratory testing services through Above Health, Inc. ("Above Health," "we," "us," or "our"). By purchasing lab tests and submitting this consent, you acknowledge and agree to the terms outlined below.

1. Purpose and Scope

This consent form establishes the terms under which you purchase and utilize laboratory testing services through Above Health. It covers consent for testing procedures, payment arrangements, and the handling of your test results.

2. Consent for Lab Testing

2.1 Adult Patients (18 Years and Older)

If you are 18 years or older and purchasing lab tests for yourself, you consent to:

• The collection of biological specimens (blood, urine, saliva, or other samples as required)
• The processing and analysis of your specimens by certified laboratories
• The sharing of your test results with Above Health's healthcare providers
• The inclusion of your test results in your medical record
• The review of your results by licensed healthcare professionals

2.2 Minor Patients and Dependents

If you are a parent or legal guardian purchasing lab tests for a minor (under 18 years):

• You represent and warrant that you have the legal authority to consent on behalf of the minor
• You consent to all testing procedures on behalf of the minor
• You acknowledge that test results will be shared with you as the legal guardian
• You agree to discuss results appropriately with the minor based on their age and maturity
• You accept responsibility for all medical decisions made based on test results

3. Payment Terms and Insurance

3.1 Cash Payment Agreement

By purchasing these lab tests, you explicitly acknowledge and agree that:

• You are choosing to pay for these tests directly (cash pay) rather than submitting to insurance
• Payment is due in full at the time of purchase
• You understand that these tests may be covered by your insurance, but you are voluntarily choosing to pay out-of-pocket
• Above Health will not submit these lab tests to your insurance company for reimbursement
• This is a cash transaction that you are entering into voluntarily

3.2 No Insurance Billing

You expressly acknowledge and agree that:

• Above Health will NOT bill your insurance for these tests
• You may NOT submit these tests to insurance for reimbursement after purchase
• Some insurance plans may consider out-of-network lab testing when determining deductibles or out-of-pocket maximums
• You should consult your insurance provider if you have questions about how cash-pay services affect your benefits
• You are waiving any right to insurance coverage for these specific tests

3.3 Pricing Transparency

All lab test prices are clearly displayed before purchase. There are no hidden fees or additional charges beyond the listed price. The price you see is the total amount you will pay.

4. Purpose of Testing

You acknowledge that you are purchasing these lab tests for one or more of the following purposes:

• Preventative Health Screening: To proactively monitor your health status and identify potential issues before symptoms appear
• Physician Direction: At the recommendation or direction of your healthcare provider
• Health Monitoring: To track ongoing health conditions or treatment effectiveness
• Personal Health Information: To gain insights into your personal health metrics and make informed health decisions

5. Laboratory Partners and Sample Collection

5.1 Certified Laboratory Partners

All lab tests are performed by CLIA-certified laboratories including:

• Quest Diagnostics: Available nationwide except in NY, NJ, and RI
• BioReference Laboratories: Serving NY, NJ, and RI residents
• Other certified partner laboratories as appropriate for specific tests

5.2 Sample Collection Requirements

Sample collection will occur at designated laboratory locations. You agree to:

• Present valid government-issued identification at the time of sample collection
• Follow all pre-test instructions (such as fasting, medication restrictions, or timing requirements)
• Allow trained phlebotomists or laboratory personnel to collect samples according to standard procedures
• Provide accurate information about medications, supplements, and health conditions that may affect results

6. Test Results and Medical Review

6.1 Result Delivery Timeline

Test results will be:

• Delivered within 24-72 hours for most standard tests
• Available through your secure Above Health patient portal
• Reviewed by Above Health healthcare providers before release
• Accompanied by explanations and recommendations when appropriate
• Stored securely in compliance with HIPAA requirements

6.2 Critical Values and Urgent Results

If your test results show critical values requiring immediate medical attention:

• You will be contacted immediately by phone at the number provided
• You may be advised to seek immediate medical care
• Your results may be shared with emergency providers if necessary for your safety
• Follow-up communication will be documented in your medical record

6.3 Result Interpretation and Follow-Up

While Above Health providers will review your results, you are encouraged to:

• Share results with your primary care physician
• Seek additional medical consultation for abnormal results
• Not make medical decisions based solely on lab results without professional consultation
• Schedule follow-up testing as recommended by healthcare providers

7. Privacy and Confidentiality

Your lab test information is protected health information under HIPAA. We will:

• Maintain the strict confidentiality of your test results
• Only share results with individuals you have authorized
• Follow all applicable federal and state privacy laws and regulations
• Not share your information with third parties without your consent, except as required by law
• Provide you with access to your complete test records upon request

For minor patients, test results will be shared with the parent or legal guardian who provided consent, subject to applicable state laws regarding minor privacy rights.

8. Risks and Limitations

8.1 Testing Risks

While laboratory testing is generally safe, potential risks include:

• Bruising, soreness, or minor bleeding at the collection site
• Lightheadedness or fainting during blood collection
• Very rare risks of infection at the collection site
• Potential for false positive or false negative results
• Anxiety related to test results

8.2 Testing Limitations

You understand and acknowledge that:

• No test is 100% accurate
• Results may be affected by various factors including medications, timing, and collection technique
• Some conditions may not be detectable through laboratory testing alone
• Additional testing or medical evaluation may be necessary
• Laboratory errors, while rare, may occur

9. Refund and Cancellation Policy

Lab test purchases are subject to the following refund policy:

• Full refund if cancelled before sample collection
• No refund after sample collection has occurred
• Refunds for testing errors or laboratory issues will be evaluated on a case-by-case basis
• Refund requests must be submitted within 30 days of purchase
• Refunds will be processed to the original payment method within 5-10 business days

10. Consent Acknowledgment

By purchasing lab tests through Above Health, you acknowledge that:

• You have read and understood this entire consent form
• You voluntarily consent to lab testing under these terms
• You understand and accept the cash payment requirement
• You have had the opportunity to ask questions about the testing process
• You are not relying on insurance coverage for these tests
• You understand the risks and limitations of testing
• If consenting for a minor, you have the legal authority to do so
• You agree to provide accurate information for test ordering and result interpretation

11. Updates to This Consent

We may update this consent form from time to time to reflect changes in our services, laboratory partners, or legal requirements. The effective date at the top of this document indicates when it was last revised. Your continued use of our lab testing services after changes constitutes acceptance of the updated terms.