Consent form for COVID-19 testing at Shevington High School (pupils)
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.
We required consent from parents for ALL pupils attending Shevington High School.

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 Shevington High school about the testing, ask questions and have had these answered satisfactorily, based on the information presented in the letter dated 12th January 2021 and the attached Privacy Notice.
2. 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 If on the day of testing they do not wish to take part, then they will not be made to do so and consent can be withdrawn at any time ahead of the test.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 my child having a nose and throat swab for lateral flow tests. My child will self-swab if my child is able to otherwise I understand that assistance is available but may need to be arranged for a different time.
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day of testing they do not wish to take part, then I understand they will not be made to do so and that consent can be withdrawn at any time ahead of the test.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 child’s sample(s) will be tested for the presence of COVID-19.
6. I understand that if my child’s result(s) are negative on the lateral flow test I will not be contacted by Shevington High School except where they are a close contact of a confirmed positive.
7. If the lateral flow test indicates the presence of COVID-19, I consent to my child having a nose and throat swab for confirmatory PCR testing. They will follow the instructions on the PCR Kit to return the test the same day to an NHS Test & Trace laboratory.
8. If the lateral flow test indicates the presence of COVID-19, I commit to ensuring that my child is removed from school premises as promptly as possible, bearing in mind they may have some anxiety following a positive test result.
9. I consent that they will need to self-isolate following a positive lateral flow test result, until the results of the confirmatory PCR have been received.
10. I agree that if my child’s test results are confirmed to be positive from this PCR test, I will report this to Shevington High School and I understand that my child will be required to self-isolate following public health advice.
11. I consent that if a close contact of my child tests positive but my child has tested negative, they will continue to attend school but will be tested every day at school for 7 days.

GDPR
Shevington High School may wish to hold the information collected in our COVID-19 Test Register. This information will be kept securely for a minimum of 14 days, and be destroyed within 1 month testing programme ending.
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Pupil's first name: *
Pupil's last name: *
Pupil's form group (e.g. 7.2) *
Pupil's date of birth *
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Pupil's gender – this information is needed for Department for Health and Social Care research purposes. *
Pupil's ethnicity - this information is needed for Department for Health and Social Care research purposes. *
Is the pupil currently showing any COVID-19 symptoms? *
Pupil's home postcode *
Email address – this is where test results will be sent *
Mobile number – this is where test results will be sent. Please do not put a landline number – you can only receive test results to a mobile number. *
Full name of parent/carer giving consent *
Relationship to test subject *
Signature (typing out your full name is sufficient if you are filling in this form digitally) *
Todays date *
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YYYY
Details of any health or accessibility issues which might affect a child’s safe participation in the testing exercise. (If there are no known issues please type N/A) *
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