Corona Virus Testing Consent

Coronavirus Lateral Flow Testing Consent Form

  1. I have had the opportunity to consider the information provided by the school about the testing, ask questions and have had these answered satisfactorily, based on the information presented in the letter and the Privacy Notice – (copies are available on the school website).
  2. In the case of under 16s, I have discussed the testing with my child and my child is happy to participate. If on the day of testing they do not wish to take part, then they will not be made to do so and consent can be withdrawn at any time ahead of the test.
  3. I consent to my child having a nose and throat swab for lateral flow tests. My child will self-swab they are able to, otherwise I understand that assistance is available. In the case of under 16s or pupils who are not able to provide informed consent, I have discussed the testing with my child and they are happy to participate and self-swab (with assistance if required).
  4. I understand that there may be multiple tests required and this consent covers all tests for the below named person. If, on the day of testing they do not wish to take part, then I understand they will not be made to do so and that consent can be withdrawn at any time ahead of the test.
  5. I consent that my child’s sample(s) will be tested for the presence of COVID-19.
  6. I understand that if my child’s result(s) are negative on the lateral flow test I will not be contacted by the school except where they are a close contact of a confirmed positive.
  7. If the lateral flow test indicates the presence of COVID-19, I consent to my child having a nose and throat swab for confirmatory PCR testing. They will follow the instructions on the PCR Kit to return the test the same day to an NHS Test & Trace laboratory.
  8. If the lateral flow test indicates the presence of COVID-19, I commit to ensuring that my child is removed from school premises as promptly as possible, bearing in mind they may have some anxiety following a positive test result.
  9. I consent that they will need to self-isolate following a positive lateral flow test result, until the results of the confirmatory PCR have been received.
  10. I agree that if my child’s test results are confirmed to be positive from this PCR test, I will report this to the school and I understand that my child will be required to self-isolate following public health advice.

Coronavirus  Consent Form

FirstName

LastName

Year group and tutor group

DateofBirth

CBCNumber

Gender
MaleFemale

Ethnicity
Asian or Asian BritishBlack, African, Black British or CaribbeanMixed or multiple ethnic groupsWhitePrefer not to say

Currently showing any COVID-19 symptoms?
NoYes

First Line Home Address

Home Postcode

Email Address – this is where test results will be sent

Mobile Number – this is where test results will be sent. Please do not put a landline number – you can only receive test results to a mobile number.

Name of parent/guardian giving consent

Relationship to test subject

Signature (typing out your name is sufficient if you are filling in this form digitally)

Date

Details of any health or accessibility issues which might affect a child’s safe participation in the testing exercise