Parent/Guardian Consent for Student Rapid COVID-19 Testing (Fort Edward School District)

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The Fort Edward 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). Fort Edward School has partnered with Adirondack Health and Wellness to provide this service. A rapid COVID-19 test will be used, which will involve inserting a small swab, similar to a Q-Tip, into the front of the nose. We will notify you if your child tests positive for COVID-19. Any student who test positive will be sent home and must be kept at home until meeting Washington County Department of Public Health 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.

To watch a brief video of the test procedure please click on the following link:
https://www.adkhw.com/covid-video

Student First Name (Please use their name in Parent Portal, not a nickname) *

Student Last Name *

Student Date of Birth *

YYYY

Student Grade *

Yes, I Consent

No, I Do Not Consent

Parent Presence at Testing *

My child may be tested without my presence.

I would like to be present when my child is tested.

I do not consent to have my child tested.

First Name of Parent/Guardian Providing Consent *

Last Name of Parent/Guardian Providing Consent *

Parent/Guardian Contact Number *

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