7. The law requires and/or allows some information about your child to be shared with Warren County and New York State Public Health Agencies. This includes notifying the Warren 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.
By digitally signing below, I attest that:
● I have signed this form freely and voluntarily, and I am legally authorized to make decisions for the child named above.
● I authorize the Queensbury Union Free School District to test my child for COVID-19 infection.
● I understand that my child may be tested at multiple times during the 2020-2021 school year.
● I understand that this consent form will be valid through June 30, 2021, unless I revoke such consent in writing.
● I authorize my child’s test results and other information to be disclosed to any governmental entity as may be required or permitted by law.
● I acknowledge that a positive test result will require my child to be sent home from school and remain at home until he/she meets the criteria to return to school according to the Warren County Department of Public Health.
● I understand that this testing does not replace treatment by my child’s medical provider, and I assume complete and full responsibility to take appropriate action regarding my child’s test results. I agree that I will seek medical advice, care, and treatment for my child from his/her medical provider if I have questions or concerns or if I become ill or my condition worsens.
● I understand that, as with any medical test, there is the potential for a false positive or false negative COVID-19 test result.
