Opt-in form for students participating in the at-home antigen test program
Opt-In Stipulations:

By completing and submitting this form, I confirm that I am the appropriate parent, guardian, or legally authorized individual to opt into the at-home antigen testing program:

Opt-in: I understand that my school district will provide the at-home antigen tests to only those students and staff, vaccinated or unvaccinated, who opt-in.

Training: I understand that my school district will provide the prerequisite at-home antigen test administration training materials, including instructions on when tests should be taken, to me. I agree to take this training prior to administering the test on my child.

Test distribution: I understand that at-home tests will be given to my student to take home every two weeks. I understand that each test kit contains two individual tests, and I will administer the test on my student on each Thursday.

Reporting test results: I understand that if my student tests positive, I will report the positive test result to my student’s school and my healthcare professional. I understand the school will keep any reported test results confidential and individual results will not be made public.

Voluntary participation: I understand that opting into the at-home antigen test program is optional and that I can choose not to participate at any time. To cancel this opt-in for the at-home antigen testing program, I need to contact your child's school nurses.

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Please enter the Parent/Guardian Last Name *
Please enter the Parent/Guardian First Name *
Please enter your Student's Last Name *
Please enter your Student's  Full First Name *
Please enter your Student's Grade Level *
Please enter your Student's School *
Opt - In *
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