COVID-19 Testing Consent Form
Parents/Guardians - please fill out a form for each student in your household.
Please select the program your student attends *
Student's Full Name *
Grade Level *
Parent/Guardian Full Name: *
Relationship to Student *
Home Phone *
Cell Phone *
Testing Consent *
In order for the district to be in compliance with the NYSDOH Mandatory COVID-19 Testing in Public Schools Located in Areas Designated as “Yellow Zones” under the New York State Cluster Action Initiative, a percentage of the students and staff must be tested for the school district located in a designated yellow zone.
If you selected 'yes', would you like to be present during your child's test?
Clear selection
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