Consent form for COVID-19 testing in secondary schools and colleges -Student

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Introduction

This consent form is for participation in tests designed to detect asymptomatic coronavirus cases. Anyone experiencing symptoms should follow government guidelines to self-isolate, even if they have had a recent negative lateral flow test.

Consent relates to the following groups of students/pupils and staff as follows:

For pupils and students younger than 16 years - this form must be completed by the parent or legal guardian. Please complete one consent form for each child you wish to participate in testing.

Pupils and students over 16 who are able to provide informed consent - can complete this form themselves, having discussed participation with their parent / guardian if under 18.

For any pupil or student who does not have the capacity to provide informed consent - this form must be completed by the parent or legal guardian. Please complete one consent form for each child you wish to participate in testing.

Terms of consent

1. I have had the opportunity to consider the information provided by the school/college about the testing, ask questions and have had these answered satisfactorily, based on the information presented and the attached Privacy Notice.

2. In the case of under 16s, I have discussed the testing with my child and my child is happy to participate. If on the day of testing they do not wish to take part, then they will not be made to do so and consent can be withdrawn at any time ahead of the test.

3. I consent to having / my child having a nose and throat swab for lateral flow tests. I / my child will self-swab if I / my child is able to otherwise I understand that assistance is available. In the case of under 16s or pupils who are not able to provide informed consent, I have discussed the testing with my child and they are happy to participate and self-swab (with assistance if required).

4. I understand that there may be multiple tests required and this consent covers all tests for the below named person. If, on the day of testing I / they do not wish to take part, then I understand I / they will not be made to do so and that consent can be withdrawn at any time ahead of the test.

5. I consent that my / my child’s sample(s) will be tested for the presence of COVID-19.

6. I understand that if my /my child’s result(s) are negative on the lateral flow test I will not be contacted by the school/college except where I am / they are a close contact of a confirmed positive.

7. If the lateral flow test indicates the presence of COVID-19, I commit to ensuring that I / my child is removed from school premises as promptly as possible, bearing in mind I / they may have some anxiety following a positive test result.

Student's Year Group (if applicable) *

First Name *

Last name *

Date of birth *

YYYY

Having read the terms of consent provided at the start of this form, do you give consent for the named student to participate in the Covid-19 Lateral Flow Testing programme at Outwood Academy City *

Yes

Gender – this information is needed for Department for Health and Social Care research purposes. We apologise that non-binary, intersex, or other gender options are not available through limitations caused by NHS Test & Trace clinical data gathering requirements. *

Ethnicity - this information will help NHS Test & Trace understand how Corona Virus is affecting people of different ethnic backgrounds *

NHS Number - Used to match GP records (optional)

Home Postcode - Used to match GP records. This is the person's permanent address *

First line of address *

Email address – this is where test results will be sent *

Mobile number for receiving test results (optional)

Currently showing any COVID-19 symptoms? *

Details of any health or accessibility issues which might affect a child’s safe participation in the testing exercise.

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