SPH Employee Health Questions

I request the opportunity to participate in a health screening and personal wellness profile conducted by the St. Peter’s Health Wellness Department. The screening involves the drawing of blood for laboratory testing, and other simple tests. I understand that my participation is entirely voluntary, that the health screening is solely for my own knowledge and benefit, and that I may stop the evaluation at any point. If this screening is part of a work place wellness program, my employer may be provided with an aggregate report. This report only includes group data, and does not include any names or personally identifiable information.I understand that there may be variances in test results, and that I should consult with my physician for a comprehensive analysis of my physical condition or any symptoms I may be experiencing. I also understand that the tests which are to be conducted are screening procedures only, not diagnostic in nature. I realize that all results are kept confidential and that it is my responsibility to follow up any abnormal result with my health care provider.I understand that I am encouraged to ask questions about the procedures used in this screening and evaluation. I have read this form and I understand the testing procedures that will be performed.I recognize and accept any risk associated with my participation in this screening and I release St. Peter’s Health from all liability, medical claims or expenses which may arise from my participation, or from any injury sustained during this event.