The Glens Falls City School District is offering weekly asymptomatic COVID-19 screening tests for students. Completing this form indicates your request and consent to test your child for COVID-19 infection using a rapid test similar to the Abbott ID Now and/or BinaxNOW COVID-19 Rapid Test.

If you consent, your child will receive a free, weekly screening test for the COVID-19 virus that will be administered by the nurse at your child's school. The testing process will involve inserting a small swab, similar to a Q-Tip, into the front of the nose. This is the simple, quick, shallow nasal swab test. Results are available in 15 minutes.

The law allows some information about your child to be shared with and among certain Warren County and New York State agencies and their contract service providers, including Warren County Public Health, New York State Department of Health, and New York State Education Department. This information will only be shared for public health purposes, which may include notifying close contacts of your child if they have been exposed to COVID-19, and taking other steps to prevent the further spread of COVID-19 in our school community. Information about your child that may be shared with with these agencies include your child’s:

    Name and COVID-19 test results
    Date of birth/age
    Gender and race/ethnicity
    School name
    Teacher name and classroom or cohort designation
    Enrollment and attendance history
    Names of siblings and guardians
    Home address, telephone number(s), and parent/guardian email address

Testing is not mandatory, and nobody will be excluded from school because they choose not be tested. Please indicate your consent below. (If you do not want your child screened for COVID-19 next week, you do not need to complete this form.)

Your responses on this form will only be used to comply with NYS DOH reporting requirements.