Student COVID-19 Testing Information & Consent Form
A COVID-19 testing strategy supports safe, in-person learning and activities while providing another lay-er of protection for students, teachers, and staff. Testing is part of a comprehensive strategy to quickly identify infection and prevent it from spreading in the school. Shawnee County schools are not required to conduct COVID-19 testing, but Auburn-Washburn is offering it as a free service for our school community.

Opt-In: A student will only be tested for COVID-19 in Auburn-Washburn with documentation of consent from the student’s parent or legal guardian.


Opt-In Test to Learn/Test to Play

Auburn-Washburn is offering a modified in-school quarantine option made available in Shawnee County. It is called Test to Learn/Test to Play because it provides a way for students to safely continue to attend school and participate in activities while in quarantine, thereby supporting academic success and social-emotional wellbeing. To participate, the student must meet eligibility criteria and parents must consent for the student to (for the duration of the quarantine) wear a mask when indoors and be tested daily with a rapid antigen and/or PCR test. The student will not be in close contact with other students or staff at school until a negative test result is known. This includes riding the bus, carpooling, and before school childcare. Those who do not consent to participate will complete quarantine at home.

Eligible students for Test to Learn/Test to Play must meet all of the following criteria:

• The student was a close contact to COVID-19.
o Within 6-feet for 10+ minutes in a 24-hour period without masks.
• The student does not already qualify for a quarantine exemption.
o Vaccine, (within past six months or boosted), Outdoors, In-school with masks appropriately worn
• The student does not have a household contact in isolation for COVID-19.
• The student has opted-in with informed consent. Those who do not opt-in must complete quarantine at home.
• Tested each school day and mask appropriately worn at school during modified quarantine period


Opt-In Symptomatic Diagnostic Testing

Schools in Auburn-Washburn will follow our normal processes for identifying and isolating students who are demonstrating symptoms of illness. If symptoms are consistent with COVID-19, a parent may request that the student will be tested at school via an antigen and/or PCR COVID-19 test.

· For students with COVID-19 symptoms if the antigen test is positive, the test can be interpreted as a true positive, which indicates the person is infected with COVID-19.

· For students with COVID-19 symptoms and the antigen test is negative, a false negative cannot be ruled out. The student must complete a PCR test for confirmation.

The purpose of this "Student COVID-19 Testing Consent Form" is for parents or legal guardians to consent to COVID-19 testing for their child at school.
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Student First Name *
Student Last Name *
Student Date of Birth *
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YYYY
School *
Parent/Guardian First Name *
Parent/Guardian Last Name *
Parent/Guardian Date of Birth *
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/
DD
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YYYY
Parent/Guardian Telephone *
Parent/Guardian Email *
Test Notification Preference *
1) Please carefully read and respond to the following informed consent for COVID-19 testing at school. *
Yes
No
For diagnostic testing:
For Test to Learn/Test to Play:
2) I understand and agree that in order to participate in Test to Learn/Test to Play modified quarantine my child must wear a mask when indoors at school and be tested daily with an antigen and/or PCR test for the duration of the modified quarantine. *
Yes
No
Daily testing:
Mask:
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