Mobile Siblingship DNA Test

Cancellation Policy

I, (Patient’s Name) authorize A.R.A. Lab Services, LLC to conduct genetic testing for Disease and/or Paternity testing, as provided voluntarily, and authorize the collection of a sample for the purpose of that testing. I acknowledge and consent to the following: 1. My technician or his/her designee (such as a genetic counselor) has fully covered the following: (a) purpose, description and nature of the test and its potential uses; (b) reliability of percentage results and the level of certainty that a positive test result for the disease or condition serves as a predictor of such disease, the effectiveness and limitations of the genetic test and the meaning of the genetic test results; (c) implications of taking the genetic test, including the medical risks and benefits; (d) description of the disease or genetic tested for; (e) the availability and importance of genetic counseling. I acknowledge that I have been provided with information identifying a genetic counselor or medical geneticist from whom I might obtain such counseling and understand that I may seek counseling prior to signing this consent; and 2. I authorize my test results to be disclosed to the following person(s):__________________________________. I understand that I will receive the test results from my physician unless I direct otherwise. I understand that I have a right to confidential treatment of my sample and results and that my test results will only be disclosed as authorized in this consent. 3. Test results will be retained in accordance with applicable laws. I understand that only my physician’s office and/or Quest Diagnostics will have access to my sample and that my sample will be used only for the purposes for which I have given my consent. Patient’s Statement I, the undersigned, have been informed about the test(s) purpose, procedures, possible benefits and risks, and I have received a copy of this consent. I have been given the opportunity to ask questions before I sign, and I have been told that I can ask other questions at any time. I voluntarily agree to genetic testing.

Contact Details

• 4200 Community Drive, West Palm Beach, FL, USA

  728-226-8475

  info@aralabservices.com

• 110 Front Street ste 300, Jupiter, FL, USA

  728-226-8475

  info@aralabservices.com