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I hereby certify that the information provided is true and accurate. I consent to the release of the above specimens for the purpose of stated test. Synapse Laboratory reserves the right to recollect specimen for retesting
and to store specimens for future additional tests. If necessary, Synapse Laboratory will not release any personal, identifiable information of any kind to a third party without my express written instructions. I also understand that Synapse Laboratory reserves the right to provide the right to provide de-identified information of a statistical nature to accrediting agencies and reserves the right to use such anonymous information.
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