I acknowledge that my role is within scope of Humana’s Vaccine and Testing policy.  Therefore, in order to comply with Humana policy, I must participate in COVID-19 testing for all weeks I conduct business activity outside my home and not submitted proof of receiving a COVID-19 vaccination and booster.  Additionally, I understand that testing may be required in certain circumstances (e.g. travel and meetings) under Humana policy.

I, the undersigned, therefore CONSENT to allow the Test Provider to make the results of business-related COVID-19 tests available to my employer and its screening vendor WithHealth, Inc., who will only provide my name, date of birth, gender, address, telephone number, and the results of my tests with my employer.

I understand the following:

  • If a test detects an active SARS-CoV-2 infection in my specimen, such information will be reported to public health authorities, and I may be required to self-quarantine for a period of time.
  • If a test does not detect active SARS-CoV-2 infection in my specimen, it does not mean that I do not have the virus, or that I have never had the virus.
  • By clicking agree and proceeding, you agree and consent for WithHealth to provide this information to Humana for the uses described in this notice, and you certify that the information you have provided herein, including the information on your COVID-19 test result upload, is accurate and complete.