Auburn School District COVID-19 Testing Consent
By completing this form, you are granting permission for your student to participate in COVID-19 testing. This permission is granted through the 2021-22 school year unless revoked in writing.

Please carefully read the following notice/informed consent and sign the authorization to test for COVID-19.

1. I understand the COVID-19 testing will be conducted through an antigen test provided by the Washington State Department of Health through their Learn to Return program or a PCR test through our Curative testing partner.
2. I understand the ability to receive testing is limited to the availability of test supplies.
3. I understand the entity/individual performing the test is not acting as a medical provider. Testing does not replace treatment by a medical provider. I assume complete and full responsibility to take appropriate action with regards to my student's test results and  medical care. I agree I will seek medical advice, care, and treatment from my student's medical provider or other health care entity if I have questions or concerns or if my student develops symptoms of COVID 19.
4. I understand that, as with any medical test, there is the potential for a false positive or false negative COVID-19 test result.
5. I understand it is my responsibility to inform my student's health care provider of a positive test result, and that a copy will not be sent to my health care provider for my student.
6. I understand that my student's antigen test result will be available in 15-30 minutes. If the result is positive, I may be referred for additional testing to confirm the result. I am responsible for obtaining further/necessary tests.
7. I understand my student's PCR test results will be available in 24-72 hours.  
8. I understand and acknowledge that a positive test result is an indication that I need to isolate my student to avoid infecting others.
9. I have been informed of the test purpose, procedures, and potential risks and benefits. I have had the opportunity to ask questions before proceeding with a COVID-19 test for my student. I understand that if my student does not wish to continue with the COVID-19 diagnostic test, he/she may decline to take the test.
10. I understand that to ensure public health and safety and to control the spread of COVID-19, my student's test results may be shared without my individual authorization.
11. I understand that my student's test results will be disclosed to the appropriate public health authorities as required by law.
12. I understand that I may withdraw my consent for my student to participate in testing at any time in writing.

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Email *
Student First Name *
Student Last Name *
My student attends: *
Student Date of Birth *
Parent/Guardian Full Name *
Parent/Guardian Phone Number *
Student Grade Level *
If grade P-5, who is your student's teacher?
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