Student Opt-In for At-Home COVID Tests
Please fill out the form below to indicate if you would like to opt-in to receiving at-home rapid antigen COVID tests, as provided by the Massachusetts Department of Elementary and Secondary Education (DESE).  Tests are iHealth tests, and if you opt in, you will be provided a box of two tests every two weeks as long as the state continues to run the program.

By opting in, you agree to administer the at-home rapid antigen test once each week, on a day identified by your child's school.  By opting in, you also agree that you will report any positive results to your child's school, as well as to your child's health care professional.

Please note that you must fill out a separate form for each student in the system.
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Name of the person filling out this form (parent/guardian if student is under 18): *
Student First Name: *
Student Last Name:
Student's School: *
Student's Grade
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Do you agree to opt-in to receive at-home rapid antigen COVID tests? *
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