Sixth Form: NHS Test and Trace consent form for COVID-19 testing

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• Students over 16 can complete this form themselves, having discussed participation with their parent / guardian if under 18

Student's surname *

Student's first name *

Student's gender *

Female

Male

Prefer not to say

What form are you in? *

Year 12 H

Year 12 F

Year 13

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 January 4th 2021 *

Yes

2. I consent to having a nose and throat swab for a lateral flow test. I will self-swab if I am able to otherwise I understand that assistance is available. *

Yes

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

Yes

4. I understand that if my result(s) are negative on the lateral flow test I will not be contacted by the school except where I am a close contact of somebody who has confirmed positive. *

Yes

5. If the lateral flow test indicates the presence of COVID-19, I consent to having a nose and throat swab for confirmatory PCR testing. I will follow the instructions on the PCR Kit to return the test the same day to an NHS Test & Trace laboratory. *

Yes

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

Yes

7. I agree that if my results are confirmed to be positive from this PCR test, I will report this to the school and I understand that I will be required to self-isolate following public health advice. *

Yes

8. I consent that if a close contact to me tests positive but I test negative, I will continue to attend school but will be tested every day at school for 7 days. *

Yes

Please provide the mobile number that we should contact if you test positive. *

Please type your full name and surname below to confirm that you have read and understood the questions in this consent form. *

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