Student COVID Surveillance Testing Form

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In accordance with the guidance issued by the New York State Department of Health, the Putnam Valley School District will be implementing COVID surveillance testing for interested students. Interested families will need to “opt in” to participate in the surveillance testing program, testing is voluntary.

The district is exploring a variety of in-school and at-home testing solutions. First, we must identify how many students will participate before deciding on how to best implement the testing program. A similar testing program for staff has been in place for several months.

Please complete the form below if you would like your child(ren) to participate in the COVID surveillance testing program. Please submit one form per child. More information will be provided as soon as we know how many students will participate in the program.

Email *

Student Last Name

Student First Name

Students' Grade

Parent Contact (Full Name)

Parent Contact (Phone Number)

Will your child participate in the District's COVID Testing Program

Yes

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