NHS Test and Trace consent form for COVID-19 testing

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This common consent form has been designed for use by parents and guardians of pupils at Saint Edmund Arrowsmith Catholic High School.

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 the letter dated 9th February 2021. *

Yes

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 If on the day of testing they do not wish to take part, then they will not be made to do so and consent can be withdrawn at any time ahead of the test. *

Yes

I consent to my child having a nose and throat swab for a lateral flow test. *

Yes

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

Yes

I understand that if my child's result is 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. *

Yes

I consent that they will need to self-isolate following a positive lateral flow test result. *

Yes

Full name of pupil being tested *

Date of Birth *

YYYY

Gender at birth *

Year group *

Currently showing any symptoms of COVID-19? *

Yes

Home Postcode *

Name of parent/ guardian *

Relationship to child *

Parent/guardian's email address *

Parent/guardian's mobile number *

Today's date *

YYYY

By submitting this form I am agreeing for my child to be tested. *

Yes

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