Blue Swab

The Ateneo de Manila University, through the Ateneo Molecular Pathology Laboratory (AMPLify), respects your privacy and aims to comply with all applicable privacy and data protection laws which includes but is not limited to the Data Privacy Act of 2012 (DPA), its implementing rules and regulations, other appropriate issuances of the National Privacy Commission, and the University's relevant data protection policies whenever we process your personal data in relation to our RT-PCR Testing Services.

Unless otherwise required or authorized by law, personal data will only be used for availing the SARS-CoV-2 diagnostic testing procedure. They will be stored and kept secure while the declared purpose of their collection subsists. Thereafter, they will be disposed of securely and permanently.

By availing of the testing services, I acknowledge the following:

I am authorizing AMPLify to process my personal data to the extent that it is necessary in providing me its RT-PCR Testing Services. This includes keeping a record of my medical history and current health conditions.
I understand and accept that it is my responsibility to provide all necessary information, such as name, phone number, email address, complete current and permanent address, medical history, travel history, recent close contact, etc;
I understand that the services require sharing/disclosure of my personal data to the Department of Health, which is bound by Mandatory Reporting of Notifiable Diseases and Public Health Concerns Act of 2019, their Implementing Rules and Regulations, and other pertinent guidelines of the Department;
I am aware that I have rights in relation to my personal data, as provided under the DPA. I may exercise any or all of those rights, within the parameters prescribed by the law; and
by providing my personal data to AMPLify, I am confirming that, to the best of my knowledge, such data are accurate, true and correct.

Should you wish to exercise any of your rights or have any concern or question regarding them, this consent form, or any matter involving the University and data privacy, you may contact AMPLify at amplify@ateneo.edu. To the extent possible, the University Data Protection Office (UDPO) will also respond to your concerns at info.udpo@ateneo.edu (inquiries) or alert.udpo@ateneo.edu (complaints/security incidents).

By agreeing to this, I hereby declare that:

I give my consent for the RT-PCR testing services.

A copy of a requisition slip from a qualified physician shall be submitted to <viber number> as a supplement for verification and confirmation of booking. The requisition slip shall contain the symptom/s (if there is/are) and the risk group classification mentioned below.

Subgroup A: Patients or healthcare workers with severe/critical symptoms, relevant history of travel/contact

Subgroup B: Patients or healthcare workers with mild symptoms, relevant history pf travel/contact, and considered vulnerable. Vulnerable populations include those elderly and with preexisting medical conditions that predispose them to severe presentation and complications of COVID-19. These also include:

Pregnant patients who shall be tested during the peripartum period;
Dialysis patients and patients on immunosuppressed states, such as those in chemotherapy or radiotherapy, who shall be tested at the discretion of the attending physician, following the existing guidelines of Philippine Society for Microbiology and Infectious Diseases

Subgroup C: Patients or healthcare workers with mild symptoms, relevant history of travel/contact

Subgroup D: Patients or healthcare workers with no symptoms but relevant history of travel/contact, with special attention to those living in confined spaces such as persons deprived of liberty or institutionalized persons

Subgroup E: Frontliners indirectly involved in health care provision in the response against COVID-19 which includes, but not limited to the following:

Personnel manning the Temporary Treatment and Quarantine Facilities (LGU- and Nationally-managed)
Personnel manning Quarantine Control Points, including those from Armed Forces of the Philippines, Bureau of Fire Protection, and others
National/Regional/Local Risk Reduction and Management Teams
Barangay Health Emergency Response teams and barangay officials providing border control and performing COVID-19 related tasks
Personnel of Bureau of Corrections and Bureau of Jail Penology and Management
Personnel manning the One-Stop-Shop in the Management of the Returning Overseas Filipinos
Personnel serving at the COVID-19 swabbing center
Social workers providing amelioration and relief assistance to communities and performing COVID-19 related tasks
All personnel (national and local) directly involved in the response against COVID-19

Subgroup F: Other vulnerable patients such as those with comorbidities like diabetes, heart diseases, etc., those will undergo high-risk elective surgical procedures, those who are pregnant, elderly, immunocompromised, and other.

	For Ateneo Employees with an authorization code issued by the HR Department Liaison. Please provide the authorization code issued to you via e-mail below:
	Full out of pocket payment. Cost 2,700Php/test but only 2,500Php/test for Sunday bookings due to non-same day results

	Pay online with credit card. Card details will not be collected by this system. You will instead be redirected to a 3rd-party site authorized to collect card information. A notification via email will be sent to you once payment is successful.
	Pay over-the-counter through bank or payment center. Payment options and other instructions will be sent via email

Step 1: RT-PCR Testing Services Data Privacy Consent

Step 3: Enter Contact Details

Step 4: Choose a Date

Step 2: Pricing Options