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By completing and submitting this form to order Discover Dysplasias™
, you are certifying and agreeing as follows: You are a licensed healthcare professional, and no patient, private health plan, government health program or any other individual or entity shall be billed for any no-charge test, and no reimbursement will be sought for any tests or materials provided at no charge in connection with such test. Access to the test at no cost is not contingent upon the recommendation, ordering, prescription or purchase of any other product or service. BioMarin and third parties acting on behalf of BioMarin may collect the information you are providing and use it to fulfill your order and communicate with you (including by email) regarding updates related to Discover Dysplasias™