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If I do not sign the Health Insurance Portability and AccountabilityAct (HIPAA) section, will it affect the test?

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If I do not sign the Health Insurance Portability and AccountabilityAct (HIPAA) section, will it affect the test?

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By signing the HIPAA authorization form, you are authorizing and directing your physician to provide Oncimmune with information regarding your bloodsample, clinical history, requisition form, test results, diagnostic steps that may be taken and results of such diagnostic steps, diagnoses, future treatment and results of such treatment and all other information developed from time totime in the future. This health information could be very helpful in the future development and refinement of EarlyCDT–Lung as well as understanding your test results, and allows our Medical Director (or other consulting physician to Oncimmune) to follow-up/consult with your physician directly about your EarlyCDT–Lungtest results. Refusing to sign does not affect testing or payment for the test.As indicated on the requisition form, you have the right to revoke the authorization at any time by contacting your physician.

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