"Parental Consent for Evaluation for Special Education Services" - Georgia (United States)

Parental Consent for Evaluation for Special Education Services is a legal document that was released by the Georgia Department of Education - a government authority operating within Georgia (United States).

Form Details:

  • Released on March 1, 2018;
  • The latest edition currently provided by the Georgia Department of Education;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of the form by clicking the link below or browse more documents and templates provided by the Georgia Department of Education.

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Download "Parental Consent for Evaluation for Special Education Services" - Georgia (United States)

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[LOCAL SCHOOL SYSTEM INFORMATION]
Parental Consent for Evaluation for
Special Education Services
__________________________
(Date)
Dear Parent of _____________________________________.
(Child’s Name)
Your child was referred by ________________________________ and was recommended for
evaluation by the Student Support Team or other appropriate source. We would like to conduct
an individual evaluation to gather more information about how to better meet your child’s needs.
If you have any questions about the evaluation process or want to know more details about the
evaluation, please contact:
Name
Title
Phone Number
You will also be invited to a meeting to discuss the evaluation and possible eligibility for Special
Education services. No changes will be made in your child’s educational program until we hold
the meeting and you provide any necessary consent. Providing this consent to evaluate does not
allow the system to provide special education services.
The individual evaluation may include these areas: learning ability, vision, hearing, motor skills,
social/emotional, achievement, speech/language or others. An explanation of these areas is
included. If you have information that you would consider helpful (e.g., evaluations, medical
reports, etc.), please provide this information to assist in determining your child’s educational
needs Your parental rights are included, which show that you have certain rights regarding
consent and evaluation procedures.
Georgia Department of Education
Model Form updated March 2018
[LOCAL SCHOOL SYSTEM INFORMATION]
Parental Consent for Evaluation for
Special Education Services
__________________________
(Date)
Dear Parent of _____________________________________.
(Child’s Name)
Your child was referred by ________________________________ and was recommended for
evaluation by the Student Support Team or other appropriate source. We would like to conduct
an individual evaluation to gather more information about how to better meet your child’s needs.
If you have any questions about the evaluation process or want to know more details about the
evaluation, please contact:
Name
Title
Phone Number
You will also be invited to a meeting to discuss the evaluation and possible eligibility for Special
Education services. No changes will be made in your child’s educational program until we hold
the meeting and you provide any necessary consent. Providing this consent to evaluate does not
allow the system to provide special education services.
The individual evaluation may include these areas: learning ability, vision, hearing, motor skills,
social/emotional, achievement, speech/language or others. An explanation of these areas is
included. If you have information that you would consider helpful (e.g., evaluations, medical
reports, etc.), please provide this information to assist in determining your child’s educational
needs Your parental rights are included, which show that you have certain rights regarding
consent and evaluation procedures.
Georgia Department of Education
Model Form updated March 2018
[LOCAL SCHOOL SYSTEM INFORMATION]
Parental Consent for Evaluation for
Special Education Services
Please sign to let us know whether or not you agree for the evaluation to take place and return
this letter to:
Name
Title
Phone Number
If you do not return this form by ___________________, we will contact you about your
decision.
(Date)
Thank you for your cooperation.
Sincerely,
Name
Title
Phone Number
 Yes, I agree for my child ________________________ to be evaluated.
 No, I do not agree for the following reasons:
Signature of Parent
Date
Attachment
Georgia Department of Education
Model Form updated March 2018
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