Customer Consents

First Name *

Last Name *

Middle Initial

Email *

Phone *

Date of birth *

Gender *

Female

Male

Other

I Consent to Receive SMS Notifications, Alerts & Occasional Marketing Communication from company. Message frequency varies. Message & data rates may apply. Text HELP to (XXX) XXX-XXXX for assistance. You can reply STOP to unsubscribe at any time.

Privacy Policy | Terms of Service

Address *

Apartment, Suite, Unit

City *

Postal code *

State *

Country *

Agree to Terms and Conditions

I understand that test results reported by BIOXPRESS LAB will be reported directly to me, in the manner chosen below. I further understand that it is my responsibility to consult my own medical doctor for interpretation, analysis, evaluation, and explanation of my test results. I understand that neither BIOXPRESS LAB nor its ordering physician will analyze, evaluate, critique, or otherwise interpret the results of said tests. I agree that BIOXPRESS LAB, its officers, shareholders, directors, employed physicians or its other agent or employee shall not be liable for any claims including, but not limited to, any claim arising out of or related to, inaccurate, uninterrupted, misinterpreted or results not received and do hereby expressly forever release and discharge all claims, demands, injuries, damage, actions or causes of action.