New Intake: Lateral Flow Testing - Consent
Please complete the following form to indicate whether or not you would like your child to participate in the two Lateral Flow Tests outlined by the Department for Education.
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Email *
Your Child's First Name *
Your Child's Surname *
Your Child's Tutor Group (e.g. 7A1) *
I give consent for my child to participate in the Lateral Flow Testing initiative outlined by the Government and the Department for Education. *
Your Child's Gender - this information is needed for the Department of Health and Social Care research purposes.
Clear selection
Your Child's Ethnicity - this information is needed for the Department of Health and Social Care research purposes.
Clear selection
Is your child currently showing any Covid-19 symptoms?
Clear selection
Home Postcode
Mobile Number - this is where test results will be sent. Please do not give a landline number - you can only receive results to a mobile device.
Name of Parent/Carer giving consent *
Relationship to the Child *
Signature - typing out your name is sufficient *
Today's Date *
MM
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DD
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YYYY
Please add details of any health or accessibility issues which might affect a child's safe participation in the testing exercise.
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