Request Your Labs — From Anywhere

By submitting this request, I acknowledge and agree to the following: 1. The lab testing requested through this form is self-directed and elective. I am requesting that these tests be ordered under the professional authorization of Birthstone Midwifery / Tayna Chessman, LM, CPM, through Professional Co-op Services, and performed by LabCorp. 2. Specimen collection takes place at an independent LabCorp patient service center. LabCorp personnel — not Birthstone Midwifery or Tayna Chessman — are solely responsible for specimen collection, handling, transport, and laboratory processing. 3. Birthstone Midwifery and Tayna Chessman, LM, CPM, are not responsible for delays, errors, lost specimens, mislabeling, or any complication arising from the collection, transport, or processing of my labs at a LabCorp facility. 4. Lab results reflect a single point in time and do not replace ongoing clinical evaluation. I agree to review any results — especially abnormal or critical results — with Tayna Chessman or another qualified healthcare provider. I understand that Birthstone Midwifery and Tayna Chessman are not liable for outcomes related to my choice to act on, delay acting on, or not act on any lab results. 5. This service is not available to residents of New Jersey or Nevada due to laboratory network restrictions, and I confirm my state of residence entered above is accurate. 6. Lab fees are collected at the time of request and are non-refundable once the lab order has been submitted to LabCorp. 7. I confirm that I am 18 years of age or older, or that I am the parent or legal guardian of the minor for whom I am requesting these labs and have the legal authority to do so. 8. To the fullest extent permitted under California law, I release Birthstone Midwifery and Tayna Chessman, LM, CPM, individually, from any and all liability, claims, damages, or causes of action related to my use of this virtual lab request service.