COVID-19 Student Testing Consent Form
COVID-19 Testing is one of the layers of mitigation that will maximize the safety of our students and staff during the 2021-2022 school year. Because testing will need to be performed regardless of a parent or guardian’s availability at the time a test will be administered, consent for testing is required for all students. The testing will be provided for students at no cost to students or their family.

Explanation of Test
The testing method  is a quick nasal swab of both nostrils. It is found to be fast and painless.  (It is NOT the deep-sinus swabs that some individuals have found uncomfortable.) The testing method involves inserting a small swab, like a Q-Tip, into the front of the nose in both nostrils. Results will be available in 15 minutes. The test is administered by either a Certified School Nurse or the School District’s medical professional testing partners. The type of test being used includes, but is not limited to, Abbott’s BinaxNOW COVID-19 Rapid Antigen Test. Molecular tests (PCR) may be identified and utilized as necessary.

The parent/guardian listed on this consent will be notified on the day that their student was tested.  All results will be communicated to the student’s parent/guardian.

Testing Guidance

Symptomatic Testing: As a reminder, as a parent/guardian you will be required to evaluate your child for COVID-19 symptoms every morning before leaving for school and to keep your child home if they do not pass the morning pre-entry health screening.  If your child passes the morning pre-entry health screening you conducted at home and arrives at school healthy, but develops symptoms of illness associated with COVID-19 infection during the school day, your child will be tested.

Symptoms include: Fever of 100.4℉ or greater, muscle or body aches, headache, sore throat, congestion or runny nose, fatigue, nausea or vomiting, diarrhea, new or persistent cough, new loss of taste or smell, shortness of breath or difficulty breathing

Test to Play/Perform (REQUIRED):  In accordance with guidance from the Philadelphia Department of Public Health (PDPH), students participating in Athletics and/or Performing Arts will be required to test 2 times weekly and/or before a competition or performance. Athletic testing will include high-contact sports only (football, volleyball, basketball, wrestling, indoor track, boys lacrosse). Performing arts testing will include band (woodwind and brass) and choir. Other sports and performing arts may be considered depending upon updated guidance. Students who are vaccinated may be able to opt out of weekly testing with proof of COVID full vaccination status. Vaccination and testing status will be monitored by the athletic directors. Those who do not consent to asymptomatic testing 2 times weekly will not be allowed to participate in sports or performing arts.

Test to Stay (OPTIONAL): When community transmission is low, and local guidance suggests, the district will implement a test to stay model after the identification of a positive case. This model allows students identified as close contacts in the cohort to be tested on 3 non-consecutive days over the period of 7 days after exposure (day 2, 4, and 6). Those individuals in the cohort who remain negative will be allowed to stay in school and not have to quarantine. Parents can opt out of the “test to stay” model and allow their student to complete the full 10 day quarantine at home. Students in quarantine will be provided instructional support.


Please contact your school nurse with any questions.
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Email *
Parent/Guardian Name *
Parent/Guardian Email Address *
Parent/Guardian Phone Number *
Child/Student Name *
Student ID Number *
Grade *
Child/Student Date of Birth *
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Do you consent to the Symptomatic Testing Model - provided onsite in schools by School Nurse or Testing Vendor *
Do you consent to the Test to Play/Perform - REQUIRED for participation in Athletics and Performing Arts *
Do you consent to the Test to Stay - In times of low community transmission, this model reduces the need to quarantine. *
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