Asymptomatic Testing Programme - Consent Form Pupils
Introduction

This consent form is for participation in tests designed to detect asymptomatic coronavirus cases. Anyone experiencing symptoms should follow government guidelines to self-isolate, even if they have had a recent negative lateral flow test.

Consent relates to the following groups of students/pupils and staff as follows:

For pupils and students younger than 16 years - this form must be completed by the parent or legal guardian.

Pupils and students over 16 who are able to provide informed consent - can complete this form themselves, having discussed participation with their parent / guardian if under 18.

For any pupil or student who does not have the capacity to provide informed consent - this form must be completed by the parent or legal guardian. Please complete one consent form for each child you wish to participate in testing.


Terms of consent

1. I have had the opportunity to consider the information provided by the school/college about the testing, ask questions and have had these answered satisfactorily, based on the information presented in the letter dated 01/01/21 and the attached Privacy Notice.

2. In the case of under 16s, 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 If on the day of testing they do not wish to take part, then they will not be made to do so and consent can be withdrawn at any time ahead of the test.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 my child having a nose and throat swab for lateral flow tests. My child will self-swab if my child is able to otherwise I understand that assistance is available. In the case of under 16s or pupils who are not able to provide informed consent, I have discussed the testing with my child and they are happy to participate and self-swab (with assistance if required).

4. I understand that there may be multiple tests required and this consent covers all tests for the below named person. If, on the day of testing they do not wish to take part, then I understand they will not be made to do so and that consent can be withdrawn at any time ahead of the test.

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

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

7. 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. I/they will follow the instructions on the PCR Kit to return the test the same day to an NHS Test & Trace laboratory.

8. If the lateral flow test indicates the presence of COVID-19, I commit to ensuring that my child is removed from school premises as promptly as possible, bearing in mind they may have some anxiety following a positive test result.

9. 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.

10. 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.

11. 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.

In order for your pupil to participate in this programme, please complete the following consent form by Monday 4th January at 3pm.

This form must be completed by the parent or legal guardian. Please complete one consent form for each child you wish to enrol.

Do not hesitate to contact the school via the admin email addresses should you require further information.
Name of Pupil *
Site attended *
Required
Date of birth *
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Gender – this information is needed for Department for Health and Social Care research purposes. *
Ethnicity - this information is needed for Department for Health and Social Care research purposes. *
Is the pupil currently showing any COVID-19 symptoms? *
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 *
Relationship to test subject *
Signature (typing out your name is sufficient for digital submission) *
Today’s date *
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DD
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