I acknowledge, consent and agree to the following:
I authorize Bioinformatics Institute of Kenya ("KIBs"), along with the specimen collection facility and those other third parties that KIBs contracts with for providing medical testing (each a "KIBs Partner"), to collect biological specimens and perform laboratory testing with my specimen for the purpose of diagnosis of diseases, screening of diseases, determination of genetic makeup, or determining biological relationship or identification.
I witnessed the labeling of my name and/or the individual's name I am consenting for on the envelope/tube or package containing the specimen.
IF THIS TEST INVOLVES A PERSON WHO IS A MINOR (UNDER 18 YEARS OF AGE) OR WHO IS OTHERWISE LEGALLY INCAPABLE OF CONSENTING, I REPRESENT AND WARRANT THAT I HAVE THE LEGAL AUTHORITY TO REQUEST AND CONSENT TO, AND WILL ASSUME ALL LEGAL RESPONSIBILITY FOR, THE COLLECTION OF THE BIOLOGICAL SPECIMEN AND THE laboratory TESTING OF SAID MINOR/PERSON. I ACKNOWLEDGE KIBs'S (AND KIBs PARTNERS') RELIANCE ON SUCH REPRESENTATIONS AND WARRANTIES AND I AGREE TO DEFEND, INDEMNIFY AND HOLD HARMLESS KIBs, EACH KIBs PARTNER, AND EACH OF THEIR RESPECTIVE OFFICERS, DIRECTORS, EMPLOYEES AND AGENTS. FROM AND AGAINST ANY AND ALL CLAIMS ARISING FROM THE COLLECTION OF THE SPECIMEN. PERFORMANCE OF THE TESTING, OR OUTCOME OF THE TEST, INCLUDING BUT NOT LIMITED TO ANY ALLEGATION THAT I DID NOT HAVE LEGAL RIGHT AND POWER TO CONSENT TO THE TAKING OF SUCH SAMPLES. OR TO ASK KIBs (OR ANY KIBs PARTNER) TO PERFORM PARENTAGE OR OTHER RELATIONSHIP TESTING.
I acknowledge and understand that if for any reason the biological specimen is inadequate for evaluation, KIBs (and each KIBs Partner) shall not be held liable if it is unable to produce test results due to insufficient specimen or due to the nature or condition of the specimen. KIBs may request additional samples, and the testing party may incur additional fees for specimen re-collection. I understand that my sample may be used for research, only after all identifiers have been removed from the sample.
I ACKNOWLEDGE AND AGREE THAT KIBs'S (AND EACH KIBs PARTNER'S) LIABILITY TO ME ARISING OUT OF OR IN ANY WAY RELATED TO THE PROVISION OF TESTING SERVICES CONTEMPLATED HEREIN SHALL NOT EXCEED THE COST OF THE TEST, AND I AGREE TO DEFEND, INDEMNIFY AND HOLD HARMLESS KIBs, EACH KIBs PARTNER, AND EACH OF THEIR RESPECTIVE OFFICERS. DIRECTORS. EMPLOYEES AND AGENTS, FROM AND AGAINST ALL FURTHER CLAIMS OR DAMAGES. IN ADDITION. I AGREE TO CONTACT KIBs IMMEDIATELY, BUT IN ANY EVENT, WITHIN 30 DAYS FROM THE DATE OF THE REPORT, IF I HAVE ANY QUESTIONS OR CONCERNS ABOUT THE TESTING PROCESS OR THE OUTCOME OF THE TEST.
I understand that KIBs and the KIBs Partners take certain precautions to protect my personal information, and I further agree to defend, indemnify and hold harmless KIBs. each KIBs Partner, and each of their respective officers, directors, employees and agents, from and against any claims, damages, expenses. and costs associated with the release of the results, or other personal/confidential information, except as such may arise out of KIBs's or any KIBs Partner's willful misconduct.
I understand that I will receive test results only when the terms of my payment plan have been fulfilled. I understand that the deposit and any partial payments are not refundable. I understand that KIBs will hold the initiator of the test primarily responsible for ensuring that full payment is made, and that KIBs will ultimately hold all tested parties individually responsible for full payment, regardless of who initiated or requested the laboratory test. In addition, I understand that I will be responsible for any collection costs and/or attorney fees associated with a third party collection of the balance due.
Each KIBs Partner is an intended third party beneficiary of, and shall have the right to enforce directly, these terms and conditions.