As part of my employment/enrollment requirements, I hereby give my consent to undergo a Pre-Employment Medical Examination (PEME) at CarePoint Medical, Diagnostic and Wellness Clinic (CarePoint)/ Magcoop Multipurpose Cooperative (Magcoop) as may be required by my company/employer/school.

I understand that the PEME may include any or all of the following procedures:

• Physical Examination – including general inspection, palpation of breasts and genital/rectal areas for both male and female patients
• Laboratory Tests – including blood and urine testing
• Other diagnostic tests such as X-ray, ultrasound, mammography, electrocardiogram, treadmill stress test, vision and hearing tests, dental examination
• Psychological or Personality Testing

I understand that the examinations will be conducted by licensed physicians and healthcare professionals in accordance with accepted medical standards. Some procedures may involve sensitive areas of the body, and I may request a same-sex examiner for those portions of the examination. I understand that I have the right to ask questions and withdraw from any procedure at any time.

I certify that the medical history and all other information I declare will be true, accurate, and complete.

I understand that any false or misleading statements or concealment of facts may disqualify me from employment and related benefits, and release my company/employer/school, CarePoint, Magcoop, their physicians, and allied health personnel from any legal or administrative liability.

I authorize:

• The release of my previous medical records from any health professionals, health institutions, and public authorities to CarePoint and Magcoop.
• CarePoint and Magcoop to release the results of this examination and related information to my company/employer/school.
• The collection, use, disclosure, processing, and release of my personal data for identity verification, medical history documentation, record-keeping, reporting, and updates on my medical status.