Consent to Testing

COVID-19 diagnostic tests require the collection of an appropriate sample by a healthcare worker through a nasal swab, oral swab, or other recommended collection procedures. There are risks and benefits associated with undergoing a diagnostic test for COVID-19. The swab may cause sneezing and/or watering of the eyes. There is also the potential for false positive or false negative test results. Those seeking COVID-19 diagnostic testing will not incur any costs for the COVID-19 diagnostic tests that are performed.

The University of Pennsylvania, Penn Medicine and the Hospital of the University of Pennsylvania may use and share the information gathered in connection with screening testing for the following purposes:

• To minimize the risk of COVID-19 exposure to the community and direct individuals to appropriate care.
• To facilitate evaluation, additional testing, treatment, and/or follow-up related to COVID-19;
• To identify patterns of infection that may warrant additional public health interventions and/or resources;
• To facilitate disclosure based on participants' documented express consent; or
• As otherwise required or permitted by law.

Test results and any other personal information obtained during testing will be maintained securely, with access limited to those with a need to know to respond to the COVID-19 pandemic as described above. This includes people working in healthcare, as well as employees' supervisors, students' resident advisors and other University officials when necessary for COVID-19 mitigation. Such information may also be shared with federal, state and/or local public health authorities.

Participants in screening testing are responsible for taking action with regards to their test results as directed.

By agreeing below, which is intended to be the equivalent of my signature:

• I acknowledge that I have read the content of this form in its entirety, that my questions have been answered, and I consent to participate in the University of Pennsylvania’s COVID-19 screening testing program;
• I authorize the University of Pennsylvania to conduct collection, testing, and analysis for the purposes of COVID-19 diagnostic testing as described above, and I understand how the results may be used;
• I have been informed about the purpose of the COVID-19 diagnostic test, procedures to be performed, and potential risks and benefits; and
• I understand it is my responsibility to take appropriate action with respect to my test results.