Student Home Testing Result Recording Form
Please note that consent is given by opening the home test kit for use at home.

Having completed a test you should use this form to report the result to the Academy.  You must also report the result to the NHS using the website www.gov.uk/report-covid19-result or by telephone on 119.

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Name of student taking the test *
Year group of student taking the test *
Name of parent reporting test result *
Contact number of parent reporting the result (in case we need to check anything with you) *
Date test was carried out * *
MM
/
DD
/
YYYY
Unique ID number of test (under the QR code on the test) * *
Date *
MM
/
DD
/
YYYY
Result recorded * *
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