Zephyr Independent School District

K-12 COVID-19 Testing Program



Name of Person Being Tested*
Date of Birth for Person Being Tested*
Testing Location*
Is the individual a student or a faculty/staff member?*
You will need to have this number on site for testing check-in.
By clicking below, you are acknowledging that the person to be tested is a minor student, their parent or guardian must proceed with registration and consent signature.*
Parent or Guardian for the Student*
Do you consent to receiving test results via email?*

Use your mouse or finger to draw your signature above
Informed Consent Signature Date/Time*
:  

Resulting

PATIENT TEST RESULTS


Results Entry Date/Time*
:  
Name of staff member REPORTING the results:*
SARS Antigen Results*
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