Consent for Student COVID-19 Testing
The Schodack Central School District is seeking your consent to test your child for COVID-19 infection using the COVID-19 Rapid Test. The use of this rapid test would only occur if your child’s school is open for in-person instruction and falls within state guidelines for required testing. Schools that reside in a county that has a positivity rate of 9% or higher are required to test 20% of in-person students, teachers, and staff members to remain open for in-person instruction.

If you consent, your child may receive a free diagnostic test for the COVID-19 virus that will likely be administered by our school nurses or another certified or licensed medical provider (CNA, LPN, or RN) or otherwise trained and qualified individual. 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 students who test positive will be sent home and must be kept at home until meeting Rensselaer County 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.

Testing for students is not mandatory, and no one will be excluded from school because they choose not to be tested. However, if we do not receive consent from at least 20% of students and staff, we would likely be forced to shift to fully online instruction.
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Student First Name *
Student Last Name *
Student Date of Birth *
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Student Grade Level *
School Student Attends *
The law requires and/or allows some information about your child to be shared with Rensselaer County and New York State Public Health Agencies. This includes notifying Rensselaer County Public Health Services 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 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 Schodack Central 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 Rensselaer County 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.
Consent *
Required
Name of Parent/Guardian or student (if 18 years of age or older) providing/not providing consent. *
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