SARS-COV-2 Antibody Test* SARS-COV-2 Antibody Test Results* Name First Last Date of Birth MM slash DD slash YYYY Email Date MM slash DD slash YYYY ANSWERS TO THE FOLLOWING QUESTIONS:1. Does patient currently have a fever > than 100.4 Yes No 2. Does patient you have a cough, runny nose, or nasal congestion? Yes No 3. Has patient been exposed to anyone with Coronavirus? Yes No 4. Has patient recently traveled to a foreign country? Yes No TEST RESULTS:Control: Positive Negative IgG: Positive Negative IgM: Positive Negative Lot Number: Expiration: Signature COVID-19 Antibody test General Explanation of results; If your results show you tested positive for IgG, this represents a secondary antibody response, which potentially provides long-term* antibodies against SARS-COV-2 infection. If your results show you tested positive for IgM, this represents a primary antibody response, which potentially provides short-term* antibodies against SARS-COV-2 infection. If your results show you tested positive for both IgG and IgM, this indicates that you have both long-term and short-term* antibodies against SARS-COV-2 infection. *If any of your test results are positive, you have had exposure to SARS-COV-2 and now have some level of antibody protection against this virus. However, the degree to which these antibodies prevent future infection is presently unknown. Therefore, follow recommendations from the CDC, health department, and your medical team based on these test results. We at Diabetes Relief can provide no further test interpretation. *This is not a test to detect an active COVID-19 infection. IT IS A TEST TO LOOK FOR PROTECTIVE ANTIBODIES AGAINST THE VIRUS.