Student consent form for COVID-19 testing at Bideford College

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This consent form is for the participation in tests designed to detect asymptomatic coronavirus cases. Anyone experiencing symptoms should follow government guidelines to self-isolate, even if they have had a recent negative lateral flow test.

Consent relates to the following groups of students; only fill in this form if you are willing to give consent:

- For pupils and students younger than 16 years of age - this form must be completed by the parent or legal guardian. Please complete one consent form for each child you wish to participate in testing.
- Pupils and students over the age of 16 who are able to provide informed consent - can complete this form themselves, having discussed participation with their parent/guardian if under the age of 18.

For any pupil or student who does not have the capacity to provide informed consent - this form must be completed by the parent or legal guardian.

Finally, we would like to make you aware that we will process, store and share the data provided in this document with third parties. Please refer to the MAT COVID-19 Testing Privacy Statement on the College website for further details.

Email address *

First and second name of the student this form is giving consent for *

Year Group *

Tutor Group (e.g. 7EP) *

House *

Arthur

Brunel

Coleridge

Farwell

Hepworth

Date of Birth *

YYYY

Gender *

Male

Female

Ethnicity - this information is needed for Department for Health and Social Care research purposes. *

Asian or Asian British

Black, African, Black British or Caribbean

Mixed or multiple ethnic groups

White

Prefer not to say

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

Name of person giving consent (can be own name if over 16 years) *

Relationship to person this form is applicable to. *

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. *

Home Postcode - Please do not put any spaces here. *

I have had the opportunity to consider the information provided by the school including the FAQs about the testing programme. *

Yes

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. *

Yes, I have spoken to them and they understand

I consent to my child having a nose and throat swab for lateral flow tests. 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 verbal assistance if required). *

I give consent

I understand that there may be multiple tests required and this consent covers all tests for the 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. *

I understand

I consent that my child’s sample(s) will be tested for the presence of COVID-19 *

I give consent

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 case. *

I understand

If the lateral flow test indicates the presence of COVID-19, I agree to my child taking a further PCR testing kit home. They will follow the instructions on the PCR Kit to return the test the same day to an NHS Test & Trace laboratory. *

I agree

If the lateral flow test indicates the presence of COVID-19, I commit to ensuring that my child leaves the school premises as promptly as possible. *

I commit to collect my child from school as soon as possible after a positive result.

I consent that they will need to self-isolate following a positive lateral flow test result, until the results of the confirmatory PCR test have been received. *

I consent to the above

I agree that if my child’s test results are confirmed to be positive from the following 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. *

I agree

I consent that if a close contact of my child tests positive but my child has tested negative, they will continue to attend school but will be tested every day at school for 7 days*. (*This strategy has been paused but may return in the future, to cover that eventuality please consent to this by checking the option below).

I consent

Clear selection

Parent/Carer or personal signature or own name if over 16 years old (typing out your name is sufficient) *

Submit

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