Corona Testzentrum "Testzentrum im Pfarrheim Hövelhof"

Declaration of consent for the performance of a corona test

1. The sample for the antigen corona test is taken by swabbing using a cotton swab inserted into the nose. I am aware that even if the test is carried out carefully, there may be individual cases of injury, such as slight bleeding or irritation. In this awareness, I consent to the antigen corona test being performed on me.
2. In the event of a positive test result, I immediately enter domestic quarantine and initiate PCR retesting.
3. I am aware that my data (name, address, date of birth, telephone number, e-mail address) as well as my test result will be stored and, in the event of a positive test result, will be passed on to the health authorities. I understand that my personal information will not be used or shared in any other way.
4. I am aware that a negative test result cannot safely rule out infection with SARS-CoV-2, but represents a snapshot for approximately 24h and therefore a health status at the time of testing.
5. Ich willige ein, dass mir das Testergebnis als unverschlüsselte PDF-Datei per E-Mail oder per Telefonmitgeteilt wird.
6. I understand that a test can only be performed on symptom-free individuals. I am also aware that I am not allowed to eat or drink anything (including chewing gum or tobacco products) 30 minutes before the test.

Unsere Datenschutzerklärung können Sie hier nachlesen.

Declaration of consent for the transmission of the test result to the Corona Warn App

With this function, your test result can be automatically transmitted directly to the Corona Warn app, which is operated by the Federal Republic of Germany. You are thus making an important contribution to the containment of the pandemic.

Privacy notices regarding data transfer to the Corona Warning app can be found in our Privacy Policy.

You can also get the digital COVID certificate of the EU from us. This must be requested after the transfer in the Corona Warn App.

ATTENTION: The personalized transmission of the test result to the Corona Warn app is required to apply for the EU certificate.

I do not want my test result to be sent to the Corona Warn App.

I agree to anonymous transmission of my test result to the Corona Warn App.

I agree to the personalized transmission of my test result to the Corona Warn App.

Hiermit erkläre ich mein Einverständnis zum Übermitteln meines Testergebnisses und meines pseudonymen Codes an das Serversystem des RKI, damit ich mein Testergebnis mit der Corona Warn App abrufen kann. Das Testergebnis in der App kann hierbei nicht als namentlicher Testnachweis verwendet werden. Mir wurden Hinweise zum Datenschutz ausgehändigt.

Hiermit erkläre ich mein Einverständnis zum Übermitteln des Testergebnisses und meines pseudonymen Codes an das Serversystem des RKI, damit ich mein Testergebnis mit der Corona Warn App abrufen kann. Ich willige außerdem in die Übermittlung meines Namens und Geburtsdatums an die App ein, damit mein Testergebnis in der App als namentlicher Testnachweis angezeigt werden kann. Mir wurden Hinweise zum Datenschutz ausgehändigt.