Authorization for COVID 19 Testing

Authorization for COVID-19 Testing

To mitigate the spread of COVID-19, River City Education Organization, Inc. d/b/a San Jose Schools administers COVID-19 testing for students in certain situations. San Jose Schools has been designated a clinical testing center by the Department of Health and Human Services thereby authorizing San Jose Schools to use FDA approved rapid tests that require the individual to swab the inside of their nose. These tests are purchased from a third-party vendor. San Jose Schools does not warrant the correctness of the results. While these tests have a high percentage of accuracy, rapid tests sometimes result in false-positive and false-negative results.

By signing below, you hereby authorize employees of San Jose Schools to administer COVID-19 rapid tests on your student. You are also expressly authorizing San Jose Schools to interpret the results of the COVID-19 rapid test and to share the results of the COVID-19 rapid test on a need-to-know basis with those individuals associated with San Jose Schools that have a legitimate interest in knowing the results. The results will not be shared with any other persons. You will be notified if your students test positive for COVID-19. This authorization will remain in effect until the conclusion of the 2021-22 school year unless you expressly revoke this authorization in writing.

On behalf of yourself and your student, you further agree to release and hold harmless San Jose Schools, its directors, employees, agents, and representatives, from and against any claims, losses, or damages related to such COVID-19 testing, except in instances of gross negligence or willful misconduct.

I hereby acknowledge that I have read this form, agree to the terms, and authorize San Jose Schools to administer COVID-19 tests on my student.