Consent for Abbott BinaxNOW COVID-19 Testing

 What is this form?

We ask your consent to test you, your minor student (less than 18 years of age), or the minor child under your legal care (your student) for the virus that causes COVID-19 (SARS-CoV-2).

 What is the test? How much will it cost?

This COVID-19 test is an Abbott BinaxNOW Antigen Card. The test looks for pieces of SARS-CoV-2 viral protein and gives results in about 15 minutes. This test is different from a PCR (polymerase chain reaction) test for COVID-19. That test looks for SARS-CoV-2 nucleic acids, and it takes several hours or days to get test results. The Abbott BinaxNOW test is free; there is no cost to you.

 How is the test done? How long to does it take to get results? Is it painful?

A staff member will first ask you or your student some health questions. A trained staff person will insert a small swab, like a Q-Tip, about 2 centimeters into the front of the nose, swirl the swab around several times, and then follow the instructions to run the test. Some individuals may be nervous about testing, but this test is not painful and should not be uncomfortable. After testing, you or your student will be directed to a designated waiting area until the results are available in approximately 15 minutes. The entire testing process should take no more than 20 minutes from start to finish. If there is an error in the test, the test will be repeated. All staff conducting testing will follow US Centers for Disease Control guidelines for COVID-19 testing.[1]

[1] CDC guidelines Collecting, Handling, and Testing Clinical Specimens for COVID-19 available at: https://www.cdc.gov/coronavirus/2019-ncov/lab/guidelines-clinical-specimens.html

How often will I or my student be tested?

Testing will be conducted when individual is symptomatic or 2-5 days after close contact.

 How do I get my test results? What happens to my test results?

Staff will give you a form containing you or your student’s test results. A qualified person will use a computer to securely send the test result to the Arizona Department of Health Services and the Pima County Health Department. Test results and information will be used for disease investigation. These organizations operate under strict laws to protect privacy. You or your student’s information will be kept confidential. The information will only be used by those health officials that need to know to help them reduce the spread of COVID-19.

What should I do when I receive the test results?

Carefully read the information you get with your test results which will tell you what you should do next. These instructions are summarized below for each type of test result.

  • POSITIVE: A positive test result means the test found the virus that causes COVID-19 in the swab. You or your student will be required to isolate and should talk to your doctor about your test result.
  • NEGATIVE: A negative test result means the test did not find the virus that causes COVID-19 in the swab. However, you or your student could still be infected. The infection may be just starting and the amount of virus may be too little to detect. This is called a “false negative.” If you or your student have symptoms or have been exposed to someone with COVID-19, you need to quarantine and get a PCR test as soon as possible.
  • INVALID: An invalid test result means there was an error in the test. You or your child should get a PCR test as soon as possible. If you or your student have symptoms or have been exposed to someone with COVID-19, you need to quarantine.

If you need to get a PCR test, free testing locations can be found at www.pima.gov/covid19testing or by calling the Pima County Health Department at 520-724-7770. Information about how long to quarantine can be found at www.pima.gov/covid19sick or by calling the Arizona State COVID-19 Hotline at 844-542-8201.

What happens if I don’t submit a consent form?

We are unable to administer a test at this time without a consent form.

NOTIFICATION OF INFORMATION SHARING

Privacy laws allow some information about you or your child to be shared with and among certain Pima County and Arizona state agencies and their contracted service organizations. This information is shared only for public health purposes, which may include contacting you to find out your close contacts and taking other steps to prevent the further spread of COVID-19 in the community. Information about you or your child that may be shared with these agencies and service providers includes: your or your child’s name and COVID-19 test results, date of birth/age, gender, race/ethnicity, address, phone number, and email address. Sharing of information about you or your child will only be done so in accordance with applicable laws and policies protecting your privacy and the security of your or your child’s information. Test results may be shared with the:

  • Arizona Department of Health Services (AZDHS)
  • Pima County Health Department (PCHD)
  • AZDHS and PCHD contracted service providers for COVID-19 case investigation, contact tracing, and other public health functions

Abbot Binax Now Consent Form