BOCES Student COVID-19 Testing Consent Form
The New York State Department of Health (NYSDOH) has released new guidelines for schools with regard to COVID-19 micro-clusters. If a community is designated as a "yellow zone" by NYS, testing for COVID-19 would become mandatory in order for the schools in that community to remain open for on-site, in-person learning and the school district would be required to conduct testing on at least 20% of the school population over a two-week period through a random selection. Should the district be in a designated orange or red zone increased testing is required.
BOCES is making the necessary plans to prepare for a zone designation, in the event that our community receives such a designation. To prepare for the very real possibility of having to test students, we are requesting that all parents, whose children are participating in in-person learning, complete this required consent form. The test to be utilized will be a rapid test utilizing a lower nasal swab.
By completing the consent form now, BOCES will be prepared to administer testing should it become necessary. To that end, please complete this form, once for each child individually, as soon as possible.
* Required
Parent/Guardian First Name
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Your answer
Parent/Guardian Last Name
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Your answer
Parent/Guardian Phone Number
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Your answer
Parent's Email Address
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Your answer
Preferred Method of Contact
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Phone
Email
Required
Student's First Name
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Your answer
Student's Last Name
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Your answer
What is your School District of Residence
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Your answer
Student's Grade
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Choose
11th Grade
12th Grade
Do you consent to allow the Southern Westchester BOCES to test your child, the student named in this form, for COVID-19 in the event that the Southern Westchester BOCES receives a COVID-19 zone designation?
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Yes, I consent to allowing the Southern Westchester BOCES to test my child, the student named in this form, for COVID-19, in the event that the Southern Westchester BOCES is designated as a "COVID-19 Zone".
No, I DO NOT consent to allowing the Southern Westchester BOCES to test my child, the student named in this form, for COVID-19, in the event that the Southern Westchester BOCES is designated as a "COVID-19 Zone".
Electronic Signature - type your name below
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Your answer
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