Informed Consent for Genetic Testing & Reporting

Intrinsic Genomics
Consent to Collect, Store, and Use Genetic Data (Limited Purposes)

Version: 2026-04-30
Consent ID / Version: Consent 1.6

---

Plain-Language Summary (Quick Read)

• You are choosing whether Intrinsic Genomics can use your DNA results to create the reports you ordered.
• We use many research studies to translate your results into clear wellness insights (not medical care).
• You can say no or withdraw later. If you withdraw, we stop using your data and delete it within 30 days (with limited legal/security exceptions).
• If you download your report or data, we cannot control or delete copies outside our system.
• External research use is optional and is explained in a separate addendum at the end.

---

1. Voluntary Consent

You are choosing whether to allow Intrinsic Genomics to collect, analyze, store, and use your genetic data (DNA / genotype or sequence data) to create the reports and services you request.

• Participation is voluntary.
• You may decline or withdraw your consent at any time.
• If you decline or withdraw, we may not be able to create, deliver, or update your reports.

---

2. What Data We Collect

We may collect and store:

1. De-identified genetic results from our third-party sample collection / lab partner (currently Labcorp).
2. Derived data created from your results (example: variant annotations, interpretation notes, or risk/score calculations).
3. Information you provide (optional), such as health history, symptoms, or family history.

---

3. Why We Use Your Data

Your genetic data will be used only for the purposes you agree to below.

Please initial/confirm each item you consent to:

Required for service

• ☐ A. Create the reports you ordered (example: nutrition, fitness, sleep, hormones, gastro, dietary management programs).
• ☐ B. Interpret your results using reference population data and published research.

Optional service features

• ☐ C. Store your data so you can access your results later and re-generate reports.
• ☐ D. Improve or update your reports over time as science and our reporting improves (for your personal use).

Research use is NOT included here. If you want to allow research use, see the optional addendum at the end.

---

4. Who Can Access Your Data / Sharing Rules

Your data may be accessed by:

• Authorized Intrinsic Genomics staff who need it to run the service and are bound by confidentiality.
• Service providers/lab partners who help process data and are contractually limited to the permitted uses.

We do not sell your genetic data.

We do not share your genetic data with third parties unless:

• You explicitly consent, or
• We are legally required to do so (rare).

---

5. Storage, Retention, and Deletion

• We will keep your de-identified genetic data for at least 5 years, unless you withdraw consent.
• After 5 years, we may request renewed consent to continue storing your data, or we may delete it.

If you withdraw consent for storage:

• We will stop using your data for new analysis.
• We will delete your stored data within 30 days, unless we must retain limited records for legal, security, or audit purposes (for example, integrity logs).

Important: If you already downloaded a report, that copy may remain on your device or wherever you saved it.

---

6. Downloaded Copies and Responsibility 

Once reports, genetic results, or related files are downloaded, printed, forwarded, exported, or saved outside Intrinsic Genomics systems, they are outside our control. Intrinsic Genomics cannot recall, delete, update, correct, or secure externally stored copies.

To the extent permitted by law, Intrinsic Genomics is not responsible for any privacy, security, disclosure, loss, theft, unauthorized access, or misuse involving copies that are stored or shared outside Intrinsic Genomics systems (including your devices, email, cloud storage, third-party apps, storage drives, or people you choose to share with).

Nothing in this section limits rights or obligations that cannot legally be limited.

---

7. Risks, Benefits, and Limits

Risks

• Privacy risk: There is a small risk of re-identification, even with security and de-identification measures.
• Emotional impact: Learning about genetic risk can be stressful or upsetting.
• Discrimination risk: Laws like GINA may protect against some types of discrimination, but protections are not complete in every situation.
• Data breach risk: No system is perfect. We use encryption and security controls, but breaches can happen.

Benefits

• You receive a personalized genetic report that may help you make better wellness decisions.

Limits

• Results show risk or tendency, not certainty.
• A “higher risk” result does not mean you will develop a condition.
• A “lower risk” result does not guarantee protection.
• Recommendations may change as research evolves.

---

8. Not Medical Care / Not Medical Advice

Intrinsic Genomics is not a medical provider and does not provide medical diagnosis or treatment.

If you have symptoms, concerns, or major health decisions to make, you should consult a licensed clinician.

---

9. Withdraw / Revoke Consent

You can withdraw consent at any time by contacting: info@intrinsicgenomics.com

If you withdraw:

• We will stop using your data for new analysis.
• We will delete stored genetic data within 30 days (as described above).
• Reports you already downloaded may remain in your possession, but no further new analysis will be performed using your stored data.

---

10. Authorization and Signature

By signing below (or selecting “I consent” electronically), you confirm that:

• You read and understood this consent form
• You had the chance to ask questions
• You freely choose to consent to the items selected in Section 3
• You understand you can download or print a copy for your records

Name: ___________________________
Signature: ________________________ Date: _____________

OR ☐ “I consent” (electronic)

---

Research Consent Addendum (Optional)

This addendum is optional. You can still receive your Intrinsic Genomics reports if you do not consent to research.

R1. What “Research Use” Means

If you agree, Intrinsic Genomics may use de-identified versions of your genetic data and related derived data (like annotations or scores) to improve understanding of wellness topics and improve future reporting.

• “De-identified” means we remove direct identifiers like your name, email, and contact info.
• Even with de-identification, there is a small risk that data could be re-identified.

R2. What May Be Shared

If you consent, de-identified data may be:

• used internally for research and quality improvement, and/or
• shared with research partners under contracts that limit use and require security protections.

R3. What We Will Not Do

• We will not sell your identified genetic data.
• We will not share your identity with research partners through this addendum.

R4. Your Choice

Please choose one:

• ☐ YES, I consent to research use of my de-identified data as described above.
• ☐ NO, I do not consent to research use of my data.

R5. Withdrawing Research Consent

You may withdraw research consent at any time by contacting info@intrinsicgenomics.com.
After withdrawal:

• We will stop using your de-identified data for new research going forward.
• Research already completed (or already in progress in a de-identified form) may not be able to be fully removed.

Name: ___________________________
Signature: ________________________ Date: _____________