Parental Consent for Student Covid-19 Testing
The Middleburgh Central School District is seeking your consent to test your child for COVID-19. With your consent, they may receive a free PCR surveillance or diagnostic test for the COVID-19 virus. This is a saliva based test. You will have access to your child's test results. The district will also notify you if your child tests positive for COVID-19.

After providing consent, Quadrant Biosciences requires all individuals to register for the COVID-19 test. Please register by using the following link: https://app.clarifi-covid-19.com/
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Email *
1. Student First Name (not a nickname)*
2. Student Last Name*
3. Student Date of Birth*
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4. School Student Attends
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5. The law requires and/or allows some information about your child to be shared with Schoharie County and New York State Public Health Agencies. This includes notifying the Schoharie County Department of Public Health about the COVID-19 results of each student who is tested, including the student’s name, date of birth, race, ethnicity, gender, address, phone number, and result of the COVID-19 test.                                                                              
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6. Name of Parent/Guardian Providing Consent *
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