NHS Covid-19 Lateral Flow Test (LFT) Consent Form - Please only complete if you ARE providing consent.

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

NHS Covid-19 Lateral Flow Test (LFT) Consent Form - Please only complete if you ARE providing consent.

In order for your child to be able to collect LFT kits from school for home testing you must complete and submit this form. A separate form must be completed for each child in school.

Sign in to Google to save your progress. Learn more

* Indicates required question

Email *

Your email

Child's first name (Forename) *

Your answer

Child's family name (Surname) *

Your answer

What is your child's date of birth *

MM

/

DD

/

YYYY

Year group *

Year 7

Year 8

Year 9

Year 10

Year 11

Year 12

Year 13

Form group *

E

D

U

C

A

T

I

Parent/Carer name filling in this form *

Your answer

What is your relationship to the child? *

Your answer

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of Mountain Ash Comprehensive School. Report Abuse