Clarkdale Clinic is dedicated to delivering responsible, evidence-based healthcare services to our community. This Medical Declaration outlines the scope of our services, patient responsibilities, and important limitations related to medical care provided at our clinic.
By receiving services from Clarkdale Clinic, you acknowledge and agree to the terms described below.
Medical Information And Consent
By providing personal and medical information to Clarkdale Clinic, you confirm that the information is accurate and complete to the best of your knowledge.
You consent to the collection, use, and handling of your information for medical evaluation, testing, communication of results, and related administrative purposes in accordance with applicable healthcare privacy laws.
Services provided by Clarkdale Clinic may include, but are not limited to:
• COVID-19 nasal swab testing
• Antibody testing
• Evaluation of symptoms related to respiratory or viral conditions
• Patient education and medical guidance
• Follow-up communication regarding test results
You have the right to ask questions, request clarification, seek a second opinion, or decline recommended services where permitted by law.
Limitations Of Medical Services
Medical care is based on current clinical standards and available medical knowledge. While we strive to provide accurate testing and professional guidance, no healthcare provider can guarantee specific outcomes or results.
Test accuracy may be influenced by factors such as timing of exposure, symptom onset, and individual health conditions. Medical advice provided is based on the information available at the time of evaluation.
Not An Emergency Facility
Clarkdale Clinic does not operate as an emergency care center.
If you experience severe symptoms such as difficulty breathing, persistent chest pain, confusion, uncontrolled fever, or other life-threatening conditions, call 911 or go to the nearest emergency room immediately.
Patient Responsibilities
As a patient, you agree to:
• Provide accurate and complete health information
• Inform the clinic of any changes in symptoms or medical history
• Follow medical instructions and isolation guidelines when applicable
• Complete required registration forms prior to your visit
• Maintain scheduled appointments or notify the clinic if changes are needed
Active participation in your care supports safe and effective treatment.
Confidentiality
All medical records and personal information are handled in compliance with applicable privacy regulations. Information will not be disclosed without authorization except where required by law or for public health reporting.
Insurance And Payment
Patients are responsible for understanding their insurance coverage, copayments, and any out-of-pocket expenses. For questions regarding billing or payment, please contact our office directly.
Acknowledgment
By utilizing services at Clarkdale Clinic, you acknowledge that:
• You understand the nature of the services being provided
• You accept the limitations inherent in medical testing and treatment
• You agree to cooperate with clinic staff to support appropriate care
• You have had the opportunity to ask questions regarding your care
Updates
Clarkdale Clinic reserves the right to modify this Medical Declaration as needed. Updated versions will be posted on our website.