Informed Consent, Release of Records and Waiver of Liability
Current students of The Catholic University of America (“University”) who are not experiencing symptoms of COVID-19 are eligible by invitation for screening testing through the University COVID-19 Testing Program (“Program”). This surveillance testing program is intended to inform students of possible COVID-19 exposure and identify possible community spread of COVID-19 and allow the University to take precautions to ensure the health and safety of individuals and the community.
About COVID-19: COVID-19 was first identified in 2019 and is caused by a novel (or new) corona virus that had not previously been seen in humans. There are many types of human corona viruses, including some that commonly cause mild upper-respiratory tract illnesses. The disease is passed from humans infected with the disease to other humans, primarily through the passage of fluids expelled orally. There are also different strains resulting from mutations. More information about COVID-19 is available from a number of sources, including the CDC.
COVID-19 Testing: The CDC provides information on testing. The University will provide you a saliva COVID-19 PCR test that is self-administered under observation of Program testing staff.
The University has contracted with Shield T3 to provide test kits, evaluate the specimens and provide test results. There is no cost to you. Testing will be conducted on a schedule set by the Program Testing Coordinator. You will need to download the Safer Community app to your smartphone to participate in this Program and to get your test results. To ensure that your test sample meets testing parameters, you must carefully follow the instructions and directions from the Program testing staff and the test kit materials while self-administering the test.
The test results will yield useful information not only to those being tested, but also to faculty, staff, health care providers and the University to help make better decisions to protect both those being tested and those who will come in contact with them.
Test Results: Your test results will be available to you directly and confidentially on the Safer Community app. The University will receive your test results through a separate platform. All test results will be reported to the District’s COVID team for contact tracing, as required by law. As with all screening tests, the test kits you will receive and use can, in some instances, do report either false-positive or false-negative results. The current COVID-19 PCR test kit may not be effective for all mutations of the virus.
If you test positive, then you will be contacted by staff from the Dean of Students’ office and will be required to complete the required isolation period set by University guidance before returning to in-person activities. Your positive results will be shared with University campus officials with a need to know (e.g., Environment, Health and Safety, Student Health Services, Residence Life, etc.) to provide support to you, to ensure that appropriate cleaning can be completed and to assist with public health prevention measures on campus, such as contact tracing and isolation. You will also be contacted by the D.C. government to assist in preventing further spread.
If you test negative, then you probably were not infected with the virus at the time your sample was collected. The test result only means that you did not have COVID-19 at the time of testing. Continue to take steps to protect yourself and others.
Certification of Eligibility, Consent to Testing and Release of Test Results, and Release and Waiver of Liability Form
I have read and fully understand the information in this Informed Consent to COVID-19 Testing, Release of Test Results and Release and Waiver of Liability Form (“Form”) and wish to participate in this COVID-19 Testing Program (“Program”). I acknowledge that my participation in the Program is voluntary and I request to participate.
After reviewing the information provided, I have been afforded the opportunity to ask questions and, to the extent I have elected to do so, I have received satisfactory answers to my questions from the Dean of Students, Program Staff and/or I was directed to other sources to get more information.
I understand and assume all risks associated with taking this COVID-19 test and participating in this Program, and I hereby release, indemnify and hold harmless the University and Shield T3 and their officers, trustees, agents, employees and healthcare providers from any and all damages, claims, actions, liability and expenses (including costs of judgments, settlements, court costs and attorneys’ fees), regardless of the outcome of such claims or actions, arising out of or relating in any way to my decision to participate in the Program, including taking the COVID-19 test and releasing the results.
I certify that I am a current student of the University, am at least 18 years of age and am competent to complete this Form and agree to its terms. I certify that I am not currently experiencing any of the following symptoms:
- In recent contact (within 6 feet for longer than 15 minutes during a 24-hour period) with someone who tested positive for COVID-19
- Fever of 100.4⸰ or higher
- Shortness of breath or difficulty breathing
- Muscles or body aches
- New loss of taste or smell
- Sore throat
- Congestion or runny nose
- Nausea or vomiting
By my participation in this Program, I accept all the terms of this Form and confirm the truth of all the information I have provided in this Informed Consent.
Updated October 18, 2021