top of page

SAMPLE REQUEST FORM

Thanks for submitting!

Seek medical attention if the test detects a loss of olfactory function. The absence of an abnormal test does not rule out that you have a disease or other conditions. Consult a healthcare professional, if you have symptoms of concern. The results do not consist of medical diagnosis and are not in place of a medical test of any kind.

TM

© 2022 by My Safe Pass. 

bottom of page