Student Consent for COVID-19 Rapid Test
The Governor's Micro-Cluster Action Initiative and the New York State Department of Health (NYSDOH) requires schools providing in-person instruction to test specific percentages of in-person students, teachers, and staff for COVID-19 if the school is in a designated yellow, orange, or red zone, in order to hold in-person teaching.

The Ichabod Crane Central School District (the “District”) is seeking your consent to test your child for COVID-19 infection.  If you consent, your child may receive a free diagnostic test for the COVID-19 virus that will be administered by a certified or licensed medical provider (CNA, LPN, or RN).  A rapid COVID-19 test (BinaxNow Antigen Test) will be used, which will involve inserting a small swab, similar to a Q-Tip, approximately one inch into the front of the nose.  We will notify you prior to the administration of the test if your child is randomly selected AND you will be notified if your child tests positive for COVID-19. Any students who test positive will be sent home and must be kept at home until meeting Columbia County Department of Health quarantine criteria to return to school. Please contact your child’s doctor immediately to review the test results should your child test positive for COVID-19.  
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Student First Name (Please use their full name in the Parent Portal, not a nickname) *
Student Last Name *
Student Date of Birth *
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School Student Attends *
COVID Testing Consent: *
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Name of Parent/Guardian Providing/Not Providing Consent *
Optional - reason for not providing consent if you responded no.
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