Consent to Test: I authorize Streamlabs to use my information included in this waiver solely for insurance billing purposes and for reporting test results to local health authorities. By signing this waiver, I understand that if I choose to forego entering my insurance information, I will need to provide my government-issued ID number. My information will only be shared with local health authorities and Streamlabs' billing team.

I hereby acknowledge that all information I have entered is true, accurate and best of my knowledge. Testing Company is not liable for any errors or omissions.

NOTE: According to HRSA guidelines as a provider of healthcare services, we are supposed to bill the respective insurances, and in case anyone does not provide insurance, denies having insurance. As the first line of approach we will try to find if the patient has insurance for those to whom the service has been provided, by utilizing insurance search tools. If the insurance search tool comes up negative, then we will bill to the uninsured portal for services.