In order to comply with the Occupational Safely & Health Administration
Blood borne Pathogen Regulation (OSHA), we are requesting your consent
to submit for testing of your blood for (blood borne pathogens Hepatitis
B, Hepatitis C, or HIV) IF ANY EXPOSURE OCCURS (needle stick injury, blood
splatter) to one of our staff members or doctors. Testing will be done
at no cost to you. All information regarding an exposure is confidential
and you consent stating you will come back if called.