NHS Test and Trace student consent form for COVID-19 college testing
Please read the accompanying letter before completing this consent form.  It has been designed for use by parent / guardian of students under 16, or by students over 16.

Therefore:

For students younger than 16 years - this form must be completed by a parent or legal guardian. Please complete one consent form for each child you wish to enrol.

Students over 16 can complete this form themselves, having discussed participation with their parent / guardian.

We will send an email receipt to the address provided as proof of consent (please note that once submitted this form cannot be edited). Please contact the college if circumstances change (email: covid-testing@henrycort.org or telephone: 01329 843127) :

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Email *
Consent
1. I have had the opportunity to consider the information provided by the The Henry Cort Community College about the testing, ask questions and have had these answered satisfactorily, based on the information presented in the letter dated  22/12/2020.
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 If on the day of testing they do not wish to take part, then they will not be made to do so and consent can be withdrawn at any time ahead of the test.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 college 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 college 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 college but will be tested every day at college for 7 days.

Legal name of student to be tested (Surname then Forename) *
Year group *
Full name of parent / guardian if under 16 (surname then forename)
Relationship to child (ie mother) if under 16
Please add any notes/comments that you feel the college needs to be aware of when conducting tests that might need to be taken into consideration.
Electronic Signature *
By submitting this form you are signing to agree to points 1-9. (please type your name as a forename then surname)
A copy of your responses will be emailed to the address you provided.
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