All Walgreens-sponsored testing sites: I confirm and certify that I am either: (a) the patient; (b) the parent or legal guardian of the patient who is a minor; or (c) the legal guardian of the patient; and that:

I consent to and authorize the testing of the patient for the novel coronavirus (SARS-CoV-2), influenza A/B and/or RSV.
I consent to and authorize the use of any individual clinical diagnostic tests for influenza A/B, RSV and/or the novel coronavirus (SARS-CoV-2) on the patient.
I acknowledge that: (i) I am aware that the test may involve the use and administration of a nasal swab to capture mucus and secretions from the patient; and (ii) use and administration of the swab is a low-risk procedure. On behalf of the patient, the patient's heirs and personal representatives, I hereby release and hold harmless Walgreens and each of its employees, contractors, agents, successors, divisions, affiliates, subsidiaries, officers, and directors from any and all liabilities or claims whether known or unknown arising out of, in connection with, or in any way related to any of either myself, the patient, a Walgreens pharmacist, or Walgreens pharmacy technician administering a nasal swab to capture mucus and secretions from the patient for use in testing for the novel coronavirus (SARS-CoV-2), influenza A/B and/or RSV.
I consent to and authorize the provider conducting the test to monitor aspects of influenza A/B, RSV and the novel coronavirus (SARS-CoV-2) virus, such as tracking viral mutations, by sequencing viruses and other microbes present in the sample(s) for epidemiological and public health purposes. Results of such analyses will not be personally identifiable nor create personally identifiable information.
I understand that the patient's participation in this testing and any records developed as a result of participation that could be used to identify the patient are confidential and will be maintained in confidence.

I have been informed about the test purpose, procedures, possible benefits and risks. I voluntarily agree to and authorize testing for influenza A/B, RSV and/or novel coronavirus (SARS-CoV-2) for the patient.