Authorization to Order Laboratory Testing and Release Results

Effective Date: March 16, 2026

Please read this Authorization carefully before completing your purchase.

By purchasing laboratory testing services through the Gut Healing Education platform operated by Microbiome Consulting, LLC d/b/a Gut Healing Education ("Company," "GHE," "we," or "us"), you ("Consumer," "I," "me," or "my") authorize the following:

1. Authorization to Order Testing on My Behalf

I authorize Gut Healing Education to order laboratory testing (including GI-MAP testing) on my behalf through DHA Laboratory ("Lab Partner"). I understand that:

• GHE will submit my personal information (including my name, date of birth, mailing address, and health history information I provide at checkout) to the Lab Partner for the purpose of processing my test order.
• My test is authorized by a licensed physician affiliated with DHA Laboratory, Inc. through its Physician Partnership Program. Gut Healing Education submits a referral on my behalf, and a DHA-affiliated physician reviews, approves, and orders the test. This physician's role is limited to authorizing the laboratory test. The ordering physician does not review my results, provide follow-up care, or offer medical advice in connection with my test. This ordering relationship does not create a provider-patient relationship between me and the ordering physician.
• I have not been referred to the Lab Partner or the Ordering Clinician by GHE. I am voluntarily electing to obtain this test through GHE's facilitation services.

2. Authorization to Receive and Deliver My Results

I hereby request and authorize the Lab Partner to release my completed test results to Gut Healing Education, acting as my authorized agent, for the sole purpose of delivering those results to me. I acknowledge that:

• The delivery of my results to me by GHE does not constitute medical advice and is not a substitute for direct communication with my own healthcare provider.
• All questions regarding the meaning, interpretation, or clinical significance of my results should be directed to my own licensed healthcare provider.
• The delivery of my results does not include any individualized medical analysis, diagnosis, treatment recommendation, or clinical opinion from GHE or any person affiliated with GHE.

3. Consent to Electronic Communication of Health Information

I consent to receive my laboratory test results and related health information from GHE via email or other electronic means to the contact information I provide.

I acknowledge and accept the following risks:

• Email and other electronic communication methods are not fully secure or confidential means of transmitting health information.
• There is a risk that third parties may be able to intercept and view electronic messages containing my laboratory test results, including: (a) individuals who have access to my personal devices; (b) my employer, if I use a work email address or network; and (c) internet service providers or other third parties who may monitor internet traffic.
• Once my results are transmitted electronically, GHE cannot control or guarantee the security of that communication.

I have been informed of these risks and voluntarily consent to the electronic delivery of my results. I understand that I may contact GHE at [email protected] before completing my purchase to discuss alternative delivery methods if I have concerns about electronic communication of my health information.

4. Acknowledgments

By signing this Authorization, I further acknowledge and agree that:

• I am at least 18 years of age.
• The information I have provided in connection with my purchase (including health history, symptoms, and dietary information) is truthful and accurate to the best of my knowledge.
• My test results may contain unexpected, concerning, or distressing findings. I accept this possibility and understand that I should consult my healthcare provider promptly if my results suggest a potentially serious condition.
• GHE is a health education and technology platform. GHE is not a medical provider, clinic, or laboratory. My use of GHE's services does not create a provider-patient relationship with GHE or any of its team members.
• The Interpretive Guide and any supplement information provided through GHE's platform are general educational resources, not individualized clinical recommendations. I am solely responsible for any decisions I make regarding my health based on my results or the Interpretive Guide.
• I will not delay seeking medical care, disregard medical advice, or discontinue medical treatment based on information I receive through GHE's services.
• This Authorization does not expire but may be revoked by me at any time by contacting GHE in writing at [email protected]. Revocation will not apply retroactively to results already delivered or information already shared pursuant to this Authorization.

I have read and understand this Authorization. I voluntarily agree to the terms above.