10-28-21

Consent or Declination for CUE COVID-19 Molecular Rapid Testing at ISD 361 Schools

ISD 361 is offering onsite weekly testing for COVID-19.  By signing this form, I acknowledge:

  • Cue testing permits students who are over 18 years of age to provide consent for testing.  For students under 18 years old, Cue testing requires a parent or legal guardian to provide consent.  Results will be available upon request and will be reported directly to the email address or phone number I provided to ISD 361.
  • ISD 361 staff trained in administering the test, and other ISD 361 staff may provide assistance.  Cue requires a trained testing supervisor to oversee each test directly.
  • ISD 361 is required to report positive cases to the Minnesota Department of Health.
  • Results will be reported to the parent after each test (positive or negative)

By signing below, I am certifying that I understand the above and that I want/do not want my child to participate in ISD 361 Schools weekly COVID-19 testing program.  I understand that I can change my mind by providing a written request to the district at any time.  Please indicate your choice below and fill out the information. 

        I DO NOT WANT MY CHILD TESTED              I WANT MY CHILD TO TEST WEEKLY

 

Student Name (print) __________________________Grade _____  Teacher______________

Signature – Parent or Legal Guardian__________________________________

Print – Parent or Legal Guardian_________________________  Date_____________________

If choosing to have child tested, Parent email or cell number for results:

_____________________________________________________________________________

(Nurse will call on a positive case, negative results would likely be texted or emailed if possible to save time.)

Testing will begin the week of November 1