Corona Testzentrum "Leipheim Innenstadt - Praxis Schwind"

Declaration of consent for the performance of a corona test

1. The sample for the antigen corona test is taken by swabbing using a cotton swab inserted into the nose. I am aware that even if the test is carried out carefully, there may be individual cases of injury, such as slight bleeding or irritation. In this awareness, I consent to the antigen corona test being performed on me.
2. In the event of a positive test result, I immediately enter domestic quarantine and initiate PCR retesting.
3. I am aware that my data (name, address, date of birth, telephone number, e-mail address) as well as my test result will be stored and, in the event of a positive test result, will be passed on to the health authorities. I understand that my personal information will not be used or shared in any other way.
4. False-positive results cannot be excluded to a certain percentage. A negative test result, on the other hand, does not mean that COVID-19 infection can be excluded with certainty. Please note that the test result is only a snapshot of the infection status at the time the test is performed. The usability or acceptance of the certificate (rapid test, antibody or PCR) or the test proof for the desired purpose must be checked by the test person in advance. Liability on the part of the issuer in the event of non-usability or non-recognition by third parties is expressly excluded.
5. I understand that a test can only be performed on symptom-free individuals. I am also aware that I am not allowed to eat or drink anything (including chewing gum or tobacco products) 30 minutes before the test.
6. If I have a nasal breathing obstruction, recent surgery in the nose area, or a blood clotting disorder, a nasopharyngeal swab cannot be performed. In this case, I will specifically inform the staff on site of this limitation in order to be tested with an alternative test method (e.g. lolly test).