05.11.2012 Views

Teaching Students with Autism Spectrum Disorders

Teaching Students with Autism Spectrum Disorders

Teaching Students with Autism Spectrum Disorders

SHOW MORE
SHOW LESS

You also want an ePaper? Increase the reach of your titles

YUMPU automatically turns print PDFs into web optimized ePapers that Google loves.

SCHOOL DISTRICT _____________<br />

PARENTAL/GUARDIAN CONSENT<br />

School Psychological Assessment/Intervention<br />

I __________________________________________________________________<br />

(Parent/Guardian)<br />

do hereby freely authorize School District _____ Psychological Services to provide the<br />

services checked above to my child _______________________________________<br />

(Name of Child)<br />

Parental permission for a student-centered behaviour consultation, intervention or<br />

psycho-educational assessment is valid for one year from the date of signature. I<br />

understand that I have a right to cancel my consent at any time.<br />

DATE: ____________________________ SIGNED: _________________________<br />

Parent/Guardian<br />

146

Hooray! Your file is uploaded and ready to be published.

Saved successfully!

Ooh no, something went wrong!