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Student Covid19 Test Consent Form - Year 10
Please complete this form to consent to your child undertaking the Lateral Flow Device testing in school
* Indicates required question
Email
*
Your email
Students' First Name
*
Your answer
Students' Surname
*
Your answer
Students' Form Group
*
10VGR
10JLL
10SRA
10ABB
10JEC
10MKO
10LDE
10AKY
Required
Date of Birth
*
MM
/
DD
/
YYYY
Gender
*
Female
Male
Ethnicity
*
Asian
Black; African;Black British or Caribbean
Mixed or multiple ethnic groups
White
Prefer not to say
Other
Is your child currently showing any coronavirus symptoms?
Yes
No
Clear selection
Home postcode
*
Your answer
Mobile
*
Your answer
Does your child have any underlying medical conditions which could affect their safe participation in testing?
*
Your answer
Your relationship to the student
Your answer
Submit
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