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Antibody Intake Form

Antibody Intake Form

  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY
  • Height
  • Relevant Past Medical History/Risk Factors
  • I understand that this test looks for antibodies to COVID-19, NOT the virus itself. Testing for viral DNA, via PCR analysis, is performed only in specifically designated places and on patients who meet a strict pre-test criteria. I am electing to have this antibody test to assess whether or not I have been exposed to the novel coronavirus in the past. I additionally understand that if I choose to have this test fewer than seven days after the resolution of symptoms, the results may be less reliable. I hereby attest that I have been advised to take this test only as a completely asymptomatic individual. I have never had symptoms or at least have been symptom-free for seven days. I also understand that the results of this test may be given to the department of health or CDC for their statistical and demographic value. Once I am given my results for this test, I understand that they are only a preliminary measure of IgG/IgM antibodies (qualitative measure) and that the values of antibodies (quantitative measures) may vary. This test does not guarantee immunity to COVID-19 or any other virus.
  • Date Format: MM slash DD slash YYYY

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Providing access to an instant point of care Our team of 30 providers delivers personalized, expert care for all of your health needs, under one roof

Wellness Services

Acupuncture
Orthopedic Care
Sports Medicine Rehabilitation
Sports Medicine
Acupuncture
Cosmetic / Plastic Surgery
Pain Management
Pain Management
Physical Therapy
Physical Therapy
Chiropractic Care
Chiropractic Care
Nutrition Weight Management
Nutrition & Weight Management
Massage Therapy
Massage Therapy
Acupuncture
Acupuncture
Spine Care
Spine Care
Diagnostic Testing
Diagnostic Testing

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New York City

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