In Compliance with the Data Privacy Act (DPA) of 2012 and its Implementing Rules and Regulations ORR), I am allowing and giving my express consent to
Philippine Airport Diagnostic Laboratory (PADLAB for brevity) to furnish and provide the details of the results of my PCR/Antigen test, including any and all
personal and sensitive personal information I provided to PADLAB in the conduct of my PCR/Antigen test to PADLAB, in accordance with its request
dated to PADLAB.
I also acknowledge and warrant that I have given my absolute consent to furnish the results of my PCR/Antigen test, including any and all personal and
sensitive personal information I provided to PADLAB in the conduct of my PCR/Antigen test to PADLAB and I hold free and harmless PADLAB from any complaint,
suit or damages which any party, including my heirs or assigns, may file or claim in relation to this consent.
Signed this day of 2021.
Complete name of Patient and Signature
By submitting, I am agreeing and giving my consent.