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Parent Consent to Test for Covid 19

Please complete the form below. Required fields marked with an asterisk *

Student Name*

Answer required for "Student Name"

Student Date of Birth*

Answer required for "Student Date of Birth"

Date symptoms first appeared

Answer required for "Date symptoms first appeared"

Parent Name*

Answer required for "Parent Name"

Parent Phone Number*

Number Required

Parent Email*

Answer required for "Parent Email"

Parental Consent to Test: As the parent or guardian of the minor student named above, I authorize Troup ISD personnel to collect and test a nasal sample from said student for the presence of SARS-CoV-2. The test being used is for rapid detection of SARS-CoV-2, which is an antigen test. Antigen tests are designed to detect proteins from the virus which causes COVID-19 illness. Furthermore, I understand the potential risks of this procedure include possible discomfort or other complications that can happen during sample collection, and possible false positive, false negative or inconclusive test results. Potential benefits include being able to use the results, along with other information, to help you make informed decisions about your care, and the results of this test may help limit the spread of COVID-19 to your family and others in your community and the campus community. *

Answer required for "Parental Consent to Test: As the parent or guardian of the minor student named above, I authorize Troup ISD personnel to collect and test a nasal sample from said student for the presence of SARS-CoV-2. The test being used is for rapid detection of SARS-CoV-2, which is an antigen test. Antigen tests are designed to detect proteins from the virus which causes COVID-19 illness. Furthermore, I understand the potential risks of this procedure include possible discomfort or other complications that can happen during sample collection, and possible false positive, false negative or inconclusive test results. Potential benefits include being able to use the results, along with other information, to help you make informed decisions about your care, and the results of this test may help limit the spread of COVID-19 to your family and others in your community and the campus community. "

I give Troup ISD permission to test my child for the COVID 19 virus.