The State of New York has determined that the Cheektowaga Central School District is located within a “Orange Zone,” as defined by the New York State Cluster Action Initiative, which requires testing of students and staff due to elevated rates of COVID-19 transmission in the area.

NYS Department of Health have recently adjusted the guidelines for Schools in “Orange” or “Red” COVID Micro-Cluster Zones. Based upon the new guideline schools are permitted to open for in-person instruction if they meet the revised testing requirement.

• Orange Zone: Test 20% of in-person staff and students over a month.
• Red Zone: Test 30% of in-person staff and students over a month.

In order to be tested, we need your consent. Students and staff will be selected on a random and voluntary basis.  All testing will be performed by our school nurses.

If tested, some information must be shared with the DOH for COVID-19 Testing, including your name and COVID-19 test results and any other data required by the Commissioner of Health. This information will be shared with the DOH for public health purposes, such as contact tracing. If any member of the school community tests positive during this process, the District will continue to follow the guidelines as outlined within the DOH and New York State Education Department reopening guidance.

By submitting the form below, I attest that:

• I have submitted this form freely and voluntarily, and in the case of a parent, I am legally authorized to make decisions for the child named above.
• I consent (for my child) to be tested for COVID-19 infection.
• I understand that I (my child) may be tested multiple times.
• I understand that this consent form will be valid through June 30, 2021, unless I notify the District in writing that I revoke my consent.
• I understand that my (my child’s) test results and other information may be disclosed as permitted by law.
• I understand that if I am a student age 18 or older, or may otherwise legally consent for my own health care, references to “my child” refer to me and I may submit this form on my own behalf.