You must complete and submit this form to finalize your registration.
I hereby agree to participate in the Siena College COVID-19 Testing Program ("Program") for the Spring 2021 semester (March 1, 2021 through May 21, 2021) . My participation in the Program is mandatory under the Siena College student pledge, and employee handbook/policy or other employer requirement. I understand that the purpose of the Program is to monitor the infection rate of COVID-19 at Siena College in an effort to provide early detection of infection rate increases.
I further agree not to participate in the program if I have previously been diagnosed with COVID-19 within 90 days prior to the date of this test. In order to be granted an exemption from an assigned testing, I understand that I must contact Jeanne Obermayer, Student Life Compliance Officer. Failure to attend a scheduled surveillance time without a prior approved exemption or excused absence/rescheduled date will be treated as noncompliance.
- Students who fail to comply with the testing requirement will be referred to the Dean of Students for disciplinary action for violations of the Code of Conduct and the COVID-19 Acknowledgement and Pledge. If students do not show up for the test and do not have prior excused absence from Student Life personnel, they will be fined and their student account will be charged.
I understand that the results of the initial test are non-diagnostic and for surveillance purposes only and as such should not be used to make any medical decisions.
I further agree and grant permission for Siena College to contact me if it is determined that I show a presumptive positive result for the test. I understand that Siena College requires and that I must obtain a confirmatory PCR test in response to presumptive positive test results at the recommendation of the State University of New York RNA Institute. Presumptive test results will also initiate immediate isolation requirements until results of the confirmatory test are received by the College.
- Students will be notified by Health Services or a Student Life designee. Students must obtain the confirmatory PCR test and submit the results to the College Health Services.
Other than the College contacting me, I understand that the College will keep the results of the test confidential to the extent allowed by law and shall use the results only to determine the presence of SARS-CoV2 in the pooled sample.
I hereby release and waive any and all liability, claims, or rights to damages of any nature against any employee, student, volunteer, agent, vendor, or contractors of Siena College, State University of New York RNA Institute or its affiliated corporations ("Released Parties") in any way arising out of my participation in the surveillance.
I further agree that this Participation Agreement shall be construed in accordance with the laws of the State of New York. In signing this Participation Agreement, I acknowledge and represent that I have read and understand it.
I agree to participate in this surveillance testing program as part of my attendance and/or employment at Siena College.