Liability Waiver

Mobile Phlebotomy Liability & Consent Agreement**

This Mobile Phlebotomy Liability & Consent Agreement (“Agreement”) is entered into between Vein & Anchor LLC (“Company”) and the undersigned client/patient (“Client”).

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1. Scope of Services

Vein & Anchor LLC agrees to provide mobile specimen collection services at the location designated by the Client. Services may include, but are not limited to:

• Venipuncture (blood draws)

• Collection of urine or other authorized specimens

• Proper handling and transport of specimens to authorized third-party laboratories

Vein & Anchor LLC does not perform laboratory testing, diagnose medical conditions, interpret results, or select tests.

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2. Client Responsibilities

The Client acknowledges and agrees that:

• All services are requested voluntarily

• Accurate and complete health information will be provided, including relevant medical conditions, allergies, medications, and history

• A safe, clean, and suitable environment will be available for specimen collection

• Failure to disclose relevant medical information may increase risk and limits the Company’s liability

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3. Risks & Assumption of Risk

The Client understands that specimen collection procedures involve inherent risks, which may include but are not limited to:

• Bruising

• Bleeding

• Fainting or dizziness

• Hematoma

• Infection

• Nerve irritation or injury

Vein & Anchor LLC follows industry-standard safety and infection-control procedures to minimize risk. The Client assumes all inherent risks associated with specimen collection.

The Company is not responsible for complications arising from:

• Undisclosed or inaccurate client information

• Pre-existing medical conditions

• Client noncompliance

• Errors, delays, or outcomes related to third-party laboratory testing

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4. Payment & Insurance

• Vein & Anchor LLC operates as a cash-only service, unless otherwise agreed in writing

• A non-refundable deposit may be required to confirm appointments

• Remaining balances are due at the time of service

• The Company does not bill insurance and is not responsible for insurance reimbursement

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5. HIPAA & Confidentiality

Vein & Anchor LLC complies with the Health Insurance Portability and Accountability Act (HIPAA). Client information will be safeguarded and disclosed only with Client authorization or as required by law.

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6. Cancellation & Rescheduling

• Appointments require advance booking

• Cancellations or reschedules must be made at least 24 hours in advance

• Deposits are non-refundable and subject to forfeiture if notice requirements are not met

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7. Indemnification & Release of Liability

To the fullest extent permitted by law, the Client agrees to release, indemnify, defend, and hold harmless Vein & Anchor LLC, including its owners, employees, contractors, and affiliates, from any claims, damages, or liabilities arising from services rendered, except in cases of gross negligence or willful misconduct.

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8. Governing Law

This Agreement shall be governed by and interpreted in accordance with the laws of the State of Nevada.

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9. Entire Agreement

This Agreement constitutes the entire understanding between the parties and supersedes all prior written or verbal agreements. Any modifications must be made in writing.

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Acknowledgment & Consent

By sliding the consent toggle ON, the Client confirms that they have:

• Read and understood this Agreement

• Had the opportunity to ask questions

• Voluntarily consented to mobile specimen collection services

• Acknowledged that consent is required before services can be performed

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Client/Patient Name:                                                                 

 

 

 

Client/Patient Signature:                                                                       

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Effective Date: 09/15/2025

Last Updated: 09/15/2025