Consent form for COVID-19 testing in secondary schools

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This common consent form has been designed for use by parents and guardians of pupils and under 16s, pupils and students over 16 and staff.
• For pupils and students younger than 16 years - this form must be completed by the parent or legal guardian. Please complete one consent form for each child you wish to enrol.
• Pupils and students over 16 can complete this form themselves, having discussed participation with their parent / guardian if under 18.
• Staff will complete this form themselves.
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 dated **********
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 If on the day of testing they do not wish to take part, then they will not be made to do so, and consent can be withdrawn at any time ahead of the test.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 having / my child having a nose and throat swab for a lateral flow test.
4. I consent that my / my child’s sample(s) will be tested for the presence of COVID-19.
5. I understand that if my child / my result(s) are negative on the lateral flow test I will not be contacted by the school except where they/you are a close contact of a confirmed positive.
6. If the lateral flow test indicates the presence of COVID-19, I consent to my child having / having a nose and throat swab for confirmatory PCR testing, which shall be sent the same day to an NHS Test & Trace laboratory.
7. I consent that I / they will need to self-isolate following a positive lateral flow test result, until the results of the confirmatory PCR have been received.
8. I agree that if my / 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 I/ my child will be required to self-isolate following public health advice.
9. I consent that if a close contact of my child tests positive, but I / my child has tested negative, I / they will continue to attend school / college but will be tested every day at school for 7 days

Email *

Student/Staff First Name *

Student/Staff Last Name *

Year group *

Date of Birth *

YYYY

First line of address *

Postcode *

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. *

Email Address - this is where test results will be sent *

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

Name of parent/carer giving permission (this acts as your electronic signature) *

Today's date *

YYYY

Relationship to student *

Gender *

Female

Male

Prefer not to say

Other:

Ethnicity *

Asian or Asian British

Black, African, Black British or Caribbean

Mixed or multiple ethnic groups

White

Prefer not to say

Send me a copy of my responses.

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