Year 10 COVID-19 Testing Pupil Consent Form - This form is for Year 10 pupils only, if you also have child in a different year group you will need to complete that specific form as well. Thank you.

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July 2021

Consent form for COVID-19 testing in secondary schools

Dear Parent / Carer

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.

Consent relates to:
All students - this form must be completed by the parent or legal guardian. Please complete one consent form for each child you wish to participate in testing.
Please see below the terms of consent and please complete the form enclosed.

Terms of consent
1. I have had the opportunity to consider the information provided by the school about the testing, ask questions and have had these answered satisfactorily, based on the information presented in this letter and the Privacy Notice on the website https://our-ladys-rc-high-school.secure-primarysite.net/covid-19-information/

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 If on the day of testing they do not wish to take part, then they will not be made to do so and consent can be withdrawn at any time ahead of the test.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. In the case of pupils who are not able to provide informed consent, I have discussed the testing with my child and they are happy to participate and self-swab (with assistance if required).

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day of testing they do not wish to take part, then I understand they will not be made to do so and that consent can be withdrawn at any time ahead of the test.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 the school.

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 the school and I understand that my child will be required to self-isolate following public health advice.

Yours faithfully

T Torr
COVID-19 Coordinator

Email *

Pupil First name *

Pupil Surname *

Pupil Date of Birth *

YYYY

Do you give consent for your child to have lateral flow COVID-19 tests on both testing dates, Thursday 26th August and Tuesday 31st August? *

Yes

Details of any health or accessibility issues which might affect safe participation in the testing exercise.

Mobile Number *

Parent Signature *

Submit

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