COVID-19 Student Testing Consent Formย  ย SY 2022 - 2023
COVID-19 Testing is one of the layers of mitigation that will maximize the safety of our students and staff during the 2022- 2023 school year. Because testing will need to be performed regardless of a parent or guardianโ€™s availability at the time a ย test will be administered, consent for testing is required for all students. The testing will be provided for students at no cost to students or their family. ย 

๐„๐ฑ๐ฉ๐ฅ๐š๐ง๐š๐ญ๐ข๐จ๐ง ๐จ๐Ÿ ๐“๐ž๐ฌ๐ญ
The testing method is a quick nasal swab of both nostrils. It is found to be fast and painless. (It is NOT the deep-sinus swabs that some individuals have found uncomfortable.) The testing method involves inserting a small swab, like a Q-Tip, ย into the front of the nose in both nostrils. Results will be available in 15 minutes. The test is administered by either a Certified School Nurse or the School Districtโ€™s medical professional testing partners. The type of test being used includes, but is not limited to, Abbottโ€™s BinaxNOW COVID-19 Rapid Antigen Test. Molecular tests (PCR) may be identified and utilized as necessary.

The parent/guardian listed on this consent will be notified on the day that their student was tested. All results will be communicated to the studentโ€™s parent/guardian. ย 

๐“๐ž๐ฌ๐ญ๐ข๐ง๐  ๐†๐ฎ๐ข๐๐š๐ง๐œ๐ž
โ— ๐’๐ฒ๐ฆ๐ฉ๐ญ๐จ๐ฆ๐š๐ญ๐ข๐œ ๐“๐ž๐ฌ๐ญ๐ข๐ง๐ : As a reminder, as a parent/guardian you will be required to evaluate your child for ย COVID-19 symptoms every morning before leaving for school and to keep your child home if they do not pass the ย morning pre-entry health screening. If your child passes the morning pre-entry health screening you conducted at ย home and arrives at school healthy, but develops symptoms of illness associated with COVID-19 infection during ย the school day, your child will be tested.ย 

Symptoms include: Fever of 100.4โ„‰ or greater, muscle or body aches, headache, sore throat, congestion ย or runny nose, fatigue, nausea or vomiting, diarrhea, new or persistent cough, new loss of taste or smell, ย shortness of breath or difficulty breathing

โ— ๐ƒ๐ข๐š๐ ๐ง๐จ๐ฌ๐ญ๐ข๐œ ๐“๐ž๐ฌ๐ญ๐ข๐ง๐  ๐๐ฎ๐ซ๐ข๐ง๐  ๐Ž๐ฎ๐ญ๐›๐ซ๐ž๐š๐ค: If your child is a part of a cohort (for example, classroom, sports team or extracurricular activity) of students with multiple positive COVID-19 cases in the cohort, your child will be tested for COVID-19.

๐๐ฅ๐ž๐š๐ฌ๐ž ๐œ๐จ๐ง๐ญ๐š๐œ๐ญ ๐ฒ๐จ๐ฎ๐ซ ๐ฌ๐œ๐ก๐จ๐จ๐ฅ ๐ง๐ฎ๐ซ๐ฌ๐ž ๐ฐ๐ข๐ญ๐ก ๐š๐ง๐ฒ ๐ช๐ฎ๐ž๐ฌ๐ญ๐ข๐จ๐ง๐ฌ
Sign in to Google to save your progress. Learn more
Next
Clear form
Never submit passwords through Google Forms.
This form was created inside of School District of Philadelphia. Report Abuse