Student Opt-in for Covid-19 at Home Testing
Please fill out this form if you would like your student to participate in our free, at home, weekly Covid-19 testing program.

Opt-in Stipulations:

1. I understand that Sturgis will provide the at-home antigen tests to only those students, vaccinated or unvaccinated, who opt-in.

2. Training: I understand that Sturgis will provide the prerequisite at-home antigen test administration materials, including instruction on when tests should be taken, to me. I agree to take this training prior to administering the test on my child.

3. Test Distribution: I understand that at-home test kits will be given to my student to take home every two weeks. I understand that each test kit contains a two week supply, and I will administer the test to my student on the designated day.

4. Reporting Results: I understand that if my student tests positive I will report the results to my student's school nurse, as well and their health care professional. I understand that Sturgis will keep any reported test results confidential.

5. Voluntary Participation: I understand that opting into the at-home antigen test program is optional and I can choose not to participate at any time.  
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Student Last Name *
Student First Name *
Campus Student Attends: *
Student Grade *
Parent Last Name *
Parent First Name *
Opt-in *
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