Covid-19 Testing Consent Form September 2021

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Please read the information below, where applicable, and complete the consent form as follows. Should you have any questions regarding this process, please contact us at coronavirus@arkgreenwich.org in the first instance.

For scholars younger than 16 years old, this form must be completed by the parent or legal guardian. Please complete one consent form per child.

Scholars over 16 years old can complete this form themselves, having discussed participation with their parent or guardian if under 18. Please note that the below format is written from the parent's perspective. Please fill in the below as usual.

Staff can complete this form themselves. Please note that the below format is written from the parent's perspective. Please fill in the below as usual. List 'staff' in the year group section.

GIVING CONSENT MEANS YOU AGREE TO:

1. I have had the opportunity to consider the information provided by the school about the testing on 4/1/2021, ask questions and have had these answered satisfactorily.

2. In the case of scholars under 16 years old, 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 If on the day of testing they do not wish to take part, then they will not be made to do so and consent can be withdrawn at any time ahead of the test.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 having my child having a nose and throat swab for a lateral flow test.

4. I consent that my child’s sample(s) will be tested for the presence of COVID-19.

5. I understand that if my child’s result(s) are negative on the lateral flow test I will not be contacted by the school except where they are a close contact of a confirmed positive case.

6. 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, which shall be sent the same day to an NHS Test & Trace laboratory.

7. 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.

8. 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.

9. I consent that if a close contact of my child tests positive but my child has tested negative, they will continue to attend school but will be tested every day at school for 7 days.

Email *

Full name of scholar or staff to be tested: *

Year and form group: *

Child or staff date of birth: *

YYYY

Child or staff gender- this information is needed for Department for Health and Social Care research purposes. *

Male

Female

Prefer not to say

Child or staff's ethnicity- this information is needed for Department for Health and Social Care research purposes. *

Asian or Asian British

Black, African, Black British or Caribbean

Mixed or multiple ethnic groups

White

Prefer not to say

Is your child currently showing any Covid-19 symptoms? *

Yes

First Line of Mailing Address: *

Home Postcode: *

Email address- this is where test results will be sent *

Mobile number- this is where test results will be sent. Please do not put a landline number; you can only receive test results to a mobile number. *

Name of parent/guardian giving consent (if under 16):

Relationship to test subject:

Signature (typing out your full name is sufficient if you are filling in this form digitally) *

Today's date: *

YYYY

A copy of your responses will be emailed to the address you provided.

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