Student COVID-19 Testing Consent Form Logo
  • Student COVID-19 Testing Consent Form

    Abbott's BinaxNOW COVID-19 Antigen Test
  • Purpose:

    To prevent the spread of COVID-19, testing, contact tracing, and isolation of infected people supports the health and safety of the community.

    Background:

    COVID-19 is an infectious disease that is spread primarily from person-to-person through respiratory droplets. Close proximity to others presents a risk of infection and disease spread. It is recommended that persons maintain six feet of distance between one another at all times; however, infection may still occur when this distance is maintained, and this distance is not always maintained.

    Agreements and Authorizations:

    • I agree to have my child participate in COVID-19 screening.
    • I authorize the nurse or trained administrative staff within The Franklin Academy to administer Abbot's BinaxNOW COVID-19 antigen test to my child. I acknowledge that this test requires a shallow nasal swab of less than one inch into the nostril.
    • I agree to obtain a PCR test for COVID-19, either through the school or community, to confirm the results if my child's rapid antigen test is positive.
    • I agree to isolate my child for at least 10 days if my child's PCR test for COVID-19 is positive or if no PCR test is taken.
    • I authorize The Franklin Academy to share my test results with the Whatcom Health Department and Washington Department of Health as required by law.

    Acknowledgements:

    I acknowledge that:

    • I voluntarily agree for my child to be tested for COVID-19.
    • I assume complete and full responsibility to take appropriate action with regard to my child's test results. A positive test result is an indication my child must self-isolate and wear a mask or face covering as directed to avoid infecting others.
    • The BinaxNOW COVID-19 rapid antigen test could result in a false positive (test is positive but on does not have the infection) or a false negative (test is negative but one has the infection).
    • My child may still be required to remain at home until he/she can safely return to school if they exhibit symptoms. A negative antigent test does not rule out COVID-19 or another infection.
    • If I have questions, concerns, or if my child's condition worsens, I will seek medical advice, care and treatment from my healthcare provider.
    • The Franklin Academy is not acting as a healthcare provider and this testing does not replace treatment by a healthcare provider.
    • I understand the purpose, procedures, possible benefits and risks of the BinaxNow rapid antigen test.
    • I can ask questions before I sign this consent form, ask additional questions at any time, and request a copy of this consent form.
    • I can contact my child's school at any time to end my child's participation in the testing program. 

    Click the link to review Abbott's BinaxNOW COVID-19 Fact Sheet

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  • COVID-19 Testing Registration

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