Diagnostic Solutions GI-MAP™ (Without Zonulin)
Terms and Conditions for Diagnostic Solutions Orders at theDr.com
I agree to the statements below:
By submitting this form, I am requesting a test kit from Dr. Tom O’Bryan and theDr.com. I understand that Dr. Tom O’Bryan and theDr.com are simply distributing the test kits and test results that are manufactured and supplied by the third party laboratory company.
I understand and agree to the fee for the service listed above, which is payable upon purchase.
All sales are final. No refunds will be afforded and you waive any rights to charge-back your purchase with your credit card processor.
Terms & Conditions:
- theDr.com does not participate in, take assignment, or accept any private insurance. We do not provide super bills and cannot assist with claim resolution for laboratory tests.
- Orders for this test are accepted from the United States only.
- TheDr.com is unable to ship test kits to the state of New York as per state laws.
- TheDr.com is unable to ship test kits to P.O. boxes. Please use a residential or business address.
- Some lab providers fill out requisition forms ahead of time with client information. To avoid confusion when processing orders, if you are ordering lab kits for multiple people, please place a separate order for each person.
- After you order a test kit, completing the test is your responsibility.
- Once theDr.com has received your test results, the results will be uploaded to your HIPAA-compliant client portal and you will receive an email instructing you how to access them.
- This test order does NOT include a test interpretation consultation. If you are interested in having your test results interpreted, please contact our former Director of Clinical Services Michelle Ross, MS, MA, CNS, LDN, IFMCP at firstname.lastname@example.org once you have received your test results. Test interpretations must take place within 3 months of placing the test order.
- Michelle Ross is a Certified Nutrition Specialist, a Licensed Dietitian-Nutritionist, and an Institute of Functional Medicine Certified Practitioner. Graduating Summa Cum Laude from the University of Bridgeport, Michelle holds a Master of Science in Human Nutrition and a master’s degree in Education from Pacific Union College. Michelle’s graduate school thesis focused on the complexity of gluten-related disorders and the potentially devastating effects of gluten on the body. She has been extensively trained in the advanced interpretation of functional testing, autoimmune diseases, gluten- and wheat- related disorders, and microbiome health.
- Please contact email@example.com with questions.
If accepted, I understand that the services provided by Dr. Tom O’Bryan and theDr.com team do not create a practitioner-patient relationship; it is purely educational and for informational purposes. I understand that theDr.com does not dispense medical advice nor prescribe treatment.
I also agree not to rely on this information as a substitute for, nor a replacement of, professional medical advice, diagnosis, or treatment. If I have any concerns or questions about my health, I understand that I should always consult with a physician or other health-care professional. I will not disregard, avoid or delay obtaining medical or health-related advice from my health-care professional because of this arrangement. The use of any information provided by theDr.com is solely at my own risk.
Neither the services provided by theDr.com nor any information provided to me is intended to suggest that I should not seek professional medical care, or that I should disregard professional medical advice. Nothing stated or made available through any services provided by theDr.com is intended to be, and must not be taken to be, the practice of medicine or the provision of health care treatment, instructions, diagnosis, prognosis, or advice.
I understand that if I am under the care of a healthcare professional or currently use prescription medications, I should discuss any potential changes with my doctor, and should not discontinue any prescription medications without first consulting my doctor.
Assumption of Risks and Releases:
I hereby release theDr.com from any and all liability, damages, causes of action, allegations, suits, sums of money, claims and demands whatsoever, in law or equity, which the Client ever had, now has, or will have in the future against theDr.com, arising from the Client’s past or future participation in, or otherwise with respect to, theDr.com’s testing services.
In no event shall theDr.com, its subsidiaries, employees, contractors be liable for lost profits or any special, incidental, consequential or multiplied damages arising out of or in connection with our services, or this agreement (HOWEVER ARISING, INCLUDING NEGLIGENCE), including, but not limited to, loss of profits, loss of use or other economic damages, even if advised of the possibility of such damages, or any failure to realize any specific benefit or health-related outcome. This limitation of liability will apply regardless of the form of action, whether in contract, tort or by statute.
Arbitration and Governing Law:
It is understood that any dispute, that is as to whether any services rendered under this contract were unnecessary or unauthorized or were improperly, negligently, or incompetently rendered, will be determined by submission to arbitration by the American Arbitration Association. Both parties to this contract, by entering into it, are giving up their constitutional rights to have any such dispute decided in a court of law before a jury, and instead are accepting the use of arbitration.
It is the intention of the parties that this agreement binds all parties whose claims may arise out of or related to service provided by theDr.com including my spouse or heirs and any children, whether born or unborn, at the time of the occurrence giving rise to any claim.
Checking the box below indicates that I have read and fully understand all terms of this agreement, including my responsibilities and assumed risks.