Below, for your information, is a copy of our Doctor Notification Agreement. This agreement will be mailed to you along with your HealthPrint laboratory kit. For your convenience, a self-addressed, stamped envelope will also be enclosed. Once this signed agreement is returned, we will be allowed to release and mail you your HealthPrint results.
Signing the Doctor Notification Agreement does not require you to have a doctor or to notify your doctor. This is your choice.
undersigned agrees that it is his or her responsibility to deliver all
laboratory test results, now and in the future, to his or her own physician for
any medical interpretation or opinion regarding any laboratory results provided
does not diagnose, cure or treat any illness or disease.
Available Out of Laboratory Reference Range results will be
indicated on the Official Lab Result form provided by YFH�
from their Nationally Certified Lab Contract Partners to the undersigned.
The Laboratories� Medical Directors will review these laboratory test
this information is not intended to, cannot, and should not be expected to,
substitute for a personal consultation with his or her own physician.
Further, the undersigned releases YFH�,
their collection sites, their lab partners, their independent representatives,
and affiliates from any and all liability for any failure to identify any
medical condition or disease.
It is understood and agreed that this is not the purpose of their
undersigned agrees that he or she will receive a nutritional interpretation
(unless it was a Test Only order) of the test results from YFH�
that are to be used by the undersigned exclusively, as an educational tool,
for personal health purposes.
However, the physician of the undersigned can use these same
laboratory results to diagnose and treat disease.
The information (as applicable) on the Your Future Health web site, YFH�
brochures, Guide�, Personal Normal Tracker�,
Health ScoreCard� as well as results and information packets are
believed to be extremely accurate but such accuracy cannot be guaranteed by YFH�,
their independent representatives, and/or affiliates as we are not the
originators of the underlying data.
The undersigned also agrees that YFH�
neither recommends nor warrants the suggestions of any health professional or
person chosen by the undersigned to assist the undersigned with understanding or
interpreting the laboratory results and/or the nutritional interpretation,
whether the name is provided by YFH�
or chosen from an independent source.
It is further agreed that the undersigned waives and releases YFH�
from any liability for any injury or loss arising out the use of, or reliance on
the recommendations, laboratory results and/or the dietary and lifestyle
suggestions provided by YFH�
and/or any health professional or person, including any and all
claims of negligence and/or product liability.
Before making any changes to the exercise or diet of the undersigned, a
health professional or doctor should be consulted.
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Orders that are canceled within 12 months from the order date will receive an in house credit in the amount of the canceled order (less a $40.00 handling fee) towards the reissue of a new kit and paperwork. The Phlebotomy envelope that contains the requisition (as well as the overnight prepaid mailer bag) must be received by YFH prior to the new test kit being reissued. The credit will be applied towards the tests selected at the time of the reissue at our current pricing. Please note�once you have been to the collection site or if a mobile examiner has come as you requested--there can be no credit, since at that point we are obligated to pay all fees and complete your order.Return To The Order Button
The undersigned agrees that YFH� does not accept or work with any insurance, Medicare, or Medicaid plans because all YFH tests are ordered for prevention and educational purposes. Under no circumstances can YFH be involved with Insurance, Medicare or Medicaid plans with or without your personal doctor's assistance.
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� Your Future Health, 2000,2013 Last Updated 04/01/2015