The fight is
not over!
Help combat the spread of
COVID-19 by getting tested when
you land in the United States.

XpresCheck and Concentric are collaborating withthe U.S. Centers for Disease Control and Prevention(CDC) to detect COVID-19 variants that could be
introduced into the U.S. by international travelers.
The CDC recommends that all international travelers(vaccinated or not) get tested 3-5 days after arrivalin the U.S.
For international travelers who are 18 years and older,we are offering free COVID-19 testing in the airport
upon arrival and through at-home testing kits.

We’re in thistogether
Help us identify COVID-19 variants entering theUnited States. Even if you took a COVID-19 test before
boarding your flight, getting tested after your flightlands will help the CDC monitor the spread of existingand new COVID-19 variants. Participation is completelyvoluntary, but is important in helping us defeat thisvirus. There is no penalty for not participating.

Frequently Asked Questions• What is a pooled test?

In-Airport TestingIf you choose to participate in the in-airport testing, youwill take a “pooled” PCR test when you get off the plane.
For this test, you will be asked to swab the inside ofyour nose with a sterile swab and place the swab into avial. Because your swab will be combined with samples

A pooled test combines samples from several people
and tests them together. A pooled test shows if anyone
in the collective pool is infected, but does not show
speciﬁcally who is infected. If you choose to participate
in the pooled test, you will be asked to swab the insideof your nose with a sterile swab.
• Will I be notified if someone in my pool is positive?

from other passengers, the results cannot be traced to

If your sample is part of a pooled test that is positive (oryou individually, but can be traced to your pool. In theindeterminate), you will be notified by XpresCheck.

event your pool tests positive for COVID-19, you will be
notified by XpresCheck via email and encouraged totake an individual diagnostic test.

At-Home TestingIf you choose to participate in at-home testing, you will
be given a test kit when you get off the plane.
You will be asked to spit into a saliva-collection tube
3-5 days after you land and ship it to the lab using apre-paid shipping envelope. You will also be asked to• What should I do if someone in my pool is positive?
You should get an individual diagnostic test using theat-home kit provided or at a local COVID-19 testing site.
• How do I get the results of my at-home test?
Before shipping your sample back to the lab, you will be
asked to set up an online account on a secure patient
portal. Your username and password can be used toaccess your test results on the portal 2-3 days later.
Further details can be found in the at-home test kit.
• What additional testing will be done on my sample?

set up an online account on a secure patient portal thatAll samples (pooled and individual) that test positive will

will enable your sample to be processed and to accessbe genetically sequenced to identify possible COVID-19

your test results. Details for setting up this accountvariants. You will not receive the sequencing results, as

are included in the test kit. Please note, your personal

it would not affect any medical care you may need.

information may be shared with local and/or state publichealth departments if you test positive for COVID-19.

PLEASE DIRECT ALL QUESTIONS TO AN
XPRESCHECK EMPLOYEE IN THE AIRPORT.

Tell us a little about yourself.

Tell us a little more.

Please provide the following information if you plan on

Vaccination Status:
Have you been vaccinated against COVID-19?
☐ Yes		
☐ No

taking the in-airport pooled test and/or at-home diagnostic
test. We will use this information to contact you, if necessary.
(You must provide this information to participate).

Family Name (Last Name)First Name

Vaccine Type (if applicable):☐ Astra Zeneca☐ Pfizer-BioNTech☐ Johnson & Johnson/Janssen ☐ Sinopharm☐ Moderna☐ Sinovax☐ Novavax☐ I don’t know
Other://
Date of Birth:Month / Day / Year

Vaccination Dose 1:

Vaccination Dose 2:

Sex: ☐ Male ☐ Female ☐ Other ☐ Prefer not to answer//
Month / Day / Year//
Month / Day / Year

What is your ethnicity?

Vaccination Dose 3:

The federal government requires this information to better
understand the impact of COVID-19 across ethnicities.

☐ Hispanic or Latino☐ Not Hispanic or Latino

What is your race? (select all that apply)
The federal government requires this information to assess racialdisparities and biases.

☐ American Indian or Alaska Native☐ Asian☐ Black or African American☐ Native Hawaiian or Other Pacific Islander☐ WhiteMobile Phone:
Email:

Airline / Flight Number			

(if applicable)(if applicable)//
Month / Day / Year
Have you ever tested positive for COVID-19?
☐ Yes		
☐ No/If yes, date of last positive test:			Month / Year

COVID-19 Testing Consent☐ I, the undersigned, conﬁrm I have read theinformation about the tests, the description of
the test samples to be collected, and the possible
risks of testing. I consent to my information being
collected and shared among XpresTest, Inc.
(“XpresCheck”), Concentric, the CDC and/or local
public health authorities.

Seat Row / Number(where you sat, not assigned)

Places visited in the last 5-10 days (City and Country):

Signature of Test Taker
Today’s Date://Month / Day / Year

PLEASE TEAR OFF THIS PAGE
AND HAND TO THE TEST ADMINISTRATOR.

Final Destination in the U.S. (City and State)

PLEASE READ CAREFULLY
Throughout the consent, “you” and “your” refer to the person whose information andsample(s) is/are being provided for testing and who will receive the services (“Test Taker”)
as may be provided under the Program. By signing this consent, you conﬁrm that you are
the Test Taker and:A. You authorize the collection and testing of pooled COVID-19 tests and/or individual
diagnostic tests as requested by the Centers for Disease Control and Prevention (includingPCR/molecular tests). You understand that all sample types will be non-invasive, short nasal
swabs or saliva. Potential risks from sample collection include discomfort from the insertionof the swabs. The irritation is expected to be brief.
B. You understand that pooled tests of this type are not required to be approved orauthorized by the FDA, and you understand pooled tests are not an FDA-approved orauthorized test nor a medical diagnostic test. You understand that individual diagnostic tests
provided by Concentric are FDA-authorized under an emergency use authorization.
C. You understand that pooled testing does not yield individual results for each member ofa pool, and that the results of the Test Taker’s individual results within a pooled test cannot
be shared with you. Test Takers may receive results of the pool. You understand the Centersfor Disease Control and Prevention in addition to the relevant local public health authorities
may receive the results of any test.
D. You understand that you will be notiﬁed about the results of any presumptive positive
or indeterminate pooled test result and/or individual diagnostic PCR or molecular test for
COVID-19 in which you participated as a Test Taker. Concentric may contact the Test Taker
regarding the pooled test result, the diagnostic/individual PCR or molecular test result, bothtest results if applicable, and/or other test-related reasons.
E. You understand that if a pooled test yields a presumptive positive or indeterminate result,
Concentric may contact you to provide an opportunity to receive and take a diagnostic/
individual PCR or molecular test.
F. Individual diagnostic tests may be used as follow-up tests if a pooled test produces apositive result. An individual diagnostic test may also be used on its own. Because diagnostic
tests provide individual results, each Test Taker will be notiﬁed of his or her results from eachdiagnostic test performed. Diagnostic testing may create Protected Health Information (PHI).
Concentric protects this information and only shares it if required (e.g., with public healthauthorities). If an individual diagnostic test yields a positive result, that individual may becontacted by public health authorities and receive additional direction from such authorities.
G. You understand that, as with any COVID-19 test, there is the potential for a false positiveor false negative COVID-19 test result and that the potential for an errant COVID-19 test
result may be higher with pooled testing than with individual testing.
H. You understand that neither Concentric, XpresCheck, nor the Centers for Disease
Control and Prevention is acting as the Test Taker’s medical provider, this testing does notreplace treatment by the Test Taker’s medical provider, and You assume complete and full
responsibility to take appropriate action with regards to the Test Taker’s test results. Youshould not make medical decisions without consulting a healthcare provider or disregard
medical advice from your healthcare provider or delay seeking such advice based on thetest results you receive from pooled or individual testing.
I. You understand that you can change your mind and cancel this permission at any time, but suchcancellation is forward-looking only, and will not aﬀect information you already permitted to bereleased. To cancel this permission for COVID-19 testing, contact support.concentricbyginkgo.com.
Relatedly, if you have questions about your test results, please contact Concentric.
J. You understand that Concentric is investigating aspects of the COVID-19 virus, such as tracking
viral mutations and you further authorize Concentric to sequence viruses and other microbes
present in the samples for epidemiological and public health purposes and to share suchsequenced viruses and/or other microbes with the Centers for Disease Control and Prevention.
K. You understand that you are providing your data to XpresCheck and Concentric by
Gingko and authorizing the use of data pursuant to the terms herein. Additional termsand conditions, Concentric’s privacy policy, and release authorizations for Concentric
testing can be found here: https://www.concentricbyginkgo.com/consent. XpresCheck andConcentric by Ginkgo assure you that your personal information is handled according toeach organization’s privacy policy and applicable privacy laws for the collection, use anddisclosure of your personal information. Neither XpresCheck nor Concentric by Ginkgo willcontact you for promotional purpose(s) unrelated to testing or sell your personal information
to any third party.

Brought to you by:
Funding for this project was made possible in part by the U.S. Centers for
Disease Control and Prevention. The views expressed in written materials orpublications do not necessarily reflect the official policies of the Department ofHealth and Human Services, nor does the mention of trade names, commercial
practices, or organizations imply endorsement by the U.S. Government.

© 2021 All rights reserved.