Insurance is verified using social security. If you do not have a social security number, you will still be able to get a test at no cost to you. This information is private and not shared outside of FlowHealth.
CONSENT TO TREATMENTThe undersigned consents to performance of medical services at Flow Health and our affiliated medical groups. This may include medical evaluation, procedures and treatment. Such procedures may include, but are not limited to: IV placement, X-rays, wound repair, blood draw and incision and drainage of abscesses. Treatment modalities include oral, intravenous, intramuscular, subcutaneous and inhaled medications, fracture treatment including splints and slings, wound repair including bio- occlusive glue and sutures. I understand that medical care is not an exact science and that no guarantee or warrantee is being made as to my examination, treatment, result or outcome. We are not an Emergency Room and are unable to provide medical services for life-threatening and/or serious illnesses. If you believe you have a life-threatening and/or serious illness, please call 911 or go directly to an Emergency Room. I understand that I am free to withdraw my consent and to discontinue participation in these procedures at any time. However, I understand that doing so may hinder my treatment and/or medical outcome. All practitioners (physicians, physician assistants) furnishing services to the undersigned are Flow Health and our affiliated medical groups are owners or independent contractors.
CONSENT TO USE AND DISCLOSE INFORMATIONI agree and consent to the use and disclose of my health information for the purpose of treatment, payment from third party payers, and other healthcare operations, such as the maintenance of medical records, communication of health information with other health professional who contribute to my care, and quality peer reviews and assessments.