COVID-19 Testing Release form
By agreeing to the information below, I attest that
     A) I authorize the school system to conduct collection and testing of my child or me (if student age 18 or older) for COVID-19 nasal swab.
    B)  I acknowledge that a positive test result is an indication that my child or me (if student age 18 or older), must self-isolate and also continue wearing a face mask or face covering as directed in an effort to avoid infecting others.
   C) I understand the school system is not acting as my child's medical provider, this testing does not replace treatment by my child's medical provider, and I assume complete and full responsibility to take appropriate action with regards to my child's test results.  I agree I will seek medical advice, care and treatment from my child's medical provided if I have questions or concerns, or if their condition worsens.
   D) I understand that, as with any medical test, there is the protential for a false positive or false negative for COVID-19 test result


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Adresse e-mail *
Child first and last name *
Child Date of Birth *
JJ
/
MM
/
YYYY
Cell/Mobile Number *
Parent/Guardian Name *
Child's Race/Ethnicity
Child's Gender
Symptoms *
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