Common Contracts
2 similar Laboratory Services Agreement contracts
EMPLOYER SOLUTIONS CLINICAL SECURE FAX FORMLaboratory Services Agreement • April 8th, 2008
Pursuant to the terms of your arrangement with Doctor’s Choice, you have directed Quest Diagnostics to release all laboratory test results to Doctor’s Choice, which is acting on your behalf as your “Business Associate” as that term is defined in the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”). Other than critical results, which will be transmitted to your office by facsimile, Doctor’s Choice will receive all the results from all of the tests that you order. By executing this document, you authorize such a disclosure of test results to Doctor’s Choice, and you represent and warrant that if required, you have obtained any appropriate consent forms or authorizations required by your patients for whom you have ordered laboratory testing. If you agree to the guidelines as explained in this communication, we will be able to begin transmitting once you have completed this form and returned it to us.
EMPLOYER SOLUTIONS CLINICAL SECURE FAX FORMLaboratory Services Agreement • April 8th, 2008
Pursuant to the terms of your arrangement with Doctor’s Choice, you have directed Quest Diagnostics to release all laboratory test results to Doctor’s Choice, which is acting on your behalf as your “Business Associate” as that term is defined in the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”). Other than critical results, which will be transmitted to your office by facsimile, Doctor’s Choice will receive all the results from all of the tests that you order. By executing this document, you authorize such a disclosure of test results to Doctor’s Choice, and you represent and warrant that if required, you have obtained any appropriate consent forms or authorizations required by your patients for whom you have ordered laboratory testing. If you agree to the guidelines as explained in this communication, we will be able to begin transmitting once you have completed this form and returned it to us.
