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By my checkmark below, I attest that I have read and understand this Sexually Transmitted Infection (“STI”) Informed Consent (“Informed Consent”) and that I consent to be tested by Flow Health Laboratories LLC (“Flow Health”) for the following STIs: · Chlamydia Trachomatis · Hepatitis B · Hepatitis C · Mycoplasma Genitalium · Neisseria Gonorrhoeae · Syphilis · Trichomonas Vaginalis · Human Immunodeficiency Virus (“HIV”) This Informed Consent is my agreeing to the ordering of clinical laboratory tests, test review services, testing, and receipt of test results (collectively, “Testing”) for all the STIs listed above. Benefits and Risk to Testing By this Consent and otherwise, I have been made aware of the potential risks and benefits associated with STI testing. Risks of Testing I understand that, by and large, there is very little risk to having a blood test. I understand that I may have slight pain or bruising at the spot where the needle is put in, but most symptoms typically go away quickly. In rare cases, I understand that the site from where my blood is drawn could become infected or bruised. A blood draw may be painful and could make me faint. As such, I am aware that the possible risks associated with blood drawing may be pain, bleeding, fainting, bruising, infection and a potential clotting of the blood under the skin at the injection site. If I had a lumbar puncture, I understand I may have pain or tenderness in my back where the needle was inserted. I may also get a headache after the procedure. The headache can last for several hours or, in rare circumstances, up to a week or more. I understand that it is my responsibility to inform any clinicians’ drawing the blood of any special circumstances or situations regarding any condition that I may have that could cause complications with my blood draw. I also understand that, depending on the stage of any STI, results may result in a false negative. For that reason, I realize it is my responsibility to return for another STI test if certain symptoms, which did not exist at the time of initial testing, exhibit themselves. If I receive an abnormal result on certain STI Tests, my name and result will be disclosed to my State health agency in accordance with applicable law. Benefits of Testing Left untreated, certain STIs can, in rare cases, cause devastating and long-term health problems such as blindness, brain damage, infertility, birth defects, and even death. Certain high-risk types of HPV can cause cervical cancer, penile cancer, and rectal and oral cancer. Some STIs can be passed from a pregnant person to the newborn, which can cause serious problems for the baby. Chlamydia and gonorrhea can cause pelvic inflammatory disease (PID). Fortunately, all STDs can be treated, and some can be cured entirely. STI testing can help you get diagnosed and treated so you may avoid serious complications. Notably, STI testing lets you know if you may have HIV or another STI. And, as a result, many STIs can be treated with antibiotics. Other benefits to STI testing include that testing can give one peace of mind, as it is the only way you can know, and your partner can know for sure if you may have HIV or an STI. In sum, STI testing protects my and my partner’s health and helps stop the spread or development of STIs; helps me get early and effective treatment; helps protect fertility, since untreated STIs can lead to infertility; and protects unborn babies from infection. Outside of rare minor irritation, there are no known risks to having urine or swab tests. Contact Information and Attestations I understand that if I have any questions before or after my Test, I can contact Flow Health by calling (323)905-0125 or emailing cs@flowhealth.com. I authorize Flow Health to use the email address and phone number I provided in connection with my account at the time I purchased my STI test (or that I updated) to contact me in connection with my STI test results. I am responsible for contacting Flow Health by calling (323)905-0125 or emailing cs@flowhealth.com to notify Flow Health of any changes to my mailing address, email address, phone number or other information that I provided in connection with my STI test or results. I understand that testing is voluntary and that I may withdraw my consent to testing at any time prior to the completion of the STI tests by contacting Flow Health by calling (323)905-0125 or emailing cs@flowhealth.com. If I test positive for an STI, I recognize that, by this Consent, I am advised to consider additional testing; get treatment from my health care provider if needed; inform any sex partners I may have of the situation; and advise that they be tested and, as necessary, treated, because STI infections can be passed back and forth. I understand that the law protects the confidentiality of test results. As required by state law, if I am positive for HIV, my name and results will be reported to my state’s health department. I understand that testing is voluntary and that I may withdraw my consent to testing at any time prior to the completion of the laboratory test by contacting Flow Health by calling (323)905-0125 or emailing cs@flowhealth.com. I attest that I am eighteen (18) years of age or older. I have read and understand the information that has been provided to me. I have been given the opportunity to ask questions about HIV testing and all my questions have been answered to my satisfaction. I have read and understood this Informed Consent STI, including HIV, testing and, hereby, consent to be tested pursuant to the terms, conditions, standards, and requirements set forth herein. *

I have reviewed the above and I attest that I have read and understand this Informed Consent and that I consent to be tested in accordance with the above.