"Cpr Sample Opt out Form" - Oklahoma

Cpr Sample Opt out Form is a legal document that was released by the Oklahoma State Department of Education - a government authority operating within Oklahoma.

Form Details:

  • The latest edition currently provided by the Oklahoma State Department of Education;
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  • 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 Oklahoma State Department of Education.

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Download "Cpr Sample Opt out Form" - Oklahoma

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Opt Out Form
Cardiopulmonary Resuscitation (CPR) Instruction
Date: __________________________
Student Name: _____________________________________________________
Beginning with the 2015-2016 school year, all students in public schools shall receive
instruction in cardiopulmonary resuscitation (CPR) at least once between ninth grade and
graduation, as required by the Dustin Rhodes and Lindsey Steed CPR Training Act (70
O.S. § 1210.199).
As required by the Act, instruction in CPR shall be based upon an instructional program
which is nationally recognized and evidence-based. School districts may use emergency
medical technicians, paramedics, police officers, firefighters, teachers, other school
employees, or other similarly qualified individuals or organizations to provide the
instruction.
_____________________ will provide instruction on ____________________ through
(LEA name)
(date)
_____________________________________________________________________.
(Identify LEA mechanism for delivering instruction. For example, Biology or Health class)
If a parent/guardian desires for his or her student to “Opt Out” of the CPR instruction
provided by the school district it must be documented in writing with parent/guardian
signature and should be kept on file by the student’s school district.
By signing this, I state that I have read the above statement and understand that I am
opting my student out of the CPR instruction provided by the school district.
________________________________________________________________________
Parent/Legal Guardian
Date
Opt Out Form
Cardiopulmonary Resuscitation (CPR) Instruction
Date: __________________________
Student Name: _____________________________________________________
Beginning with the 2015-2016 school year, all students in public schools shall receive
instruction in cardiopulmonary resuscitation (CPR) at least once between ninth grade and
graduation, as required by the Dustin Rhodes and Lindsey Steed CPR Training Act (70
O.S. § 1210.199).
As required by the Act, instruction in CPR shall be based upon an instructional program
which is nationally recognized and evidence-based. School districts may use emergency
medical technicians, paramedics, police officers, firefighters, teachers, other school
employees, or other similarly qualified individuals or organizations to provide the
instruction.
_____________________ will provide instruction on ____________________ through
(LEA name)
(date)
_____________________________________________________________________.
(Identify LEA mechanism for delivering instruction. For example, Biology or Health class)
If a parent/guardian desires for his or her student to “Opt Out” of the CPR instruction
provided by the school district it must be documented in writing with parent/guardian
signature and should be kept on file by the student’s school district.
By signing this, I state that I have read the above statement and understand that I am
opting my student out of the CPR instruction provided by the school district.
________________________________________________________________________
Parent/Legal Guardian
Date