"Parent Consent for Release of Confidential Information & Group Elearning/Teletherapy Special Education" - Oklahoma

Parent Consent for Release of Confidential Information & Group Elearning/Teletherapy Special Education is a legal document that was released by the Oklahoma State Department of Education - a government authority operating within Oklahoma.

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Download "Parent Consent for Release of Confidential Information & Group Elearning/Teletherapy Special Education" - Oklahoma

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Parent Consent for Release of Confidential
Information & Group eLearning/Teletherapy
Special Education
Student Name
Parent Name
Campus
Case Manager/Teacher/Therapist
Your child may be participating in small group lessons/therapy sessions with other students virtually. As a part
of our procedures, we require that parents/guardians are present in the home during eLearning/teletherapy. As
we support and encourage a partnership between parents and school staff in the educational process, there are
certain rights guaranteed to all students.
To ensure confidentiality and to safeguard the eLearning environment for all students, please sign below
indicating that you understand, acknowledge, and agree to comply with the following district standards
regarding confidentiality:
• I am allowed to observe other students during small group virtual lessons.
• During the time I am observing the virtual lesson, I may not interrupt instruction by talking to the teacher
or any other person in the virtual classroom.
• I may not audiotape, videotape, or photograph during the lesson.
• Every child’s right to privacy must be honored. I may not discuss my observations or confidential
information about children in the lesson including specific situations that were observed during the lesson.
• If I have concerns about my child or other students, I should discuss those concerns with the classroom
teacher, therapist, case manager, and/or campus administrator.
To continue to provide your child’s IEP services, the district requests the following release of information and
permission to provide services in a group eLearning or teletherapy environment:
• I acknowledge that it may be necessary for my child to be visible on camera for some eLearning or
eTherapy sessions and could be seen or heard by people at alternate locations
• I agree to the release of confidential information for the purposes of IEP implementation
• I understand and agree to my child’s participation in Group E-Learning, including Teletherapy.
• I have been fully informed in my native language or other mode of communication of all information
relevant to my child’s participation in Group E-Learning, including Teletherapy.
• I understand that the granting of my consent is voluntary and may be revoked at any time. If I revoke my
consent, I understand that the revocation is not retroactive and does not negate an action that has occurred
after my consent was given and before my consent was revoked.
Yes
No
Parent Signature
Date
Please contact your child’s case manager or therapist should you have any questions or need additional information.
Parent Consent for Release of Confidential
Information & Group eLearning/Teletherapy
Special Education
Student Name
Parent Name
Campus
Case Manager/Teacher/Therapist
Your child may be participating in small group lessons/therapy sessions with other students virtually. As a part
of our procedures, we require that parents/guardians are present in the home during eLearning/teletherapy. As
we support and encourage a partnership between parents and school staff in the educational process, there are
certain rights guaranteed to all students.
To ensure confidentiality and to safeguard the eLearning environment for all students, please sign below
indicating that you understand, acknowledge, and agree to comply with the following district standards
regarding confidentiality:
• I am allowed to observe other students during small group virtual lessons.
• During the time I am observing the virtual lesson, I may not interrupt instruction by talking to the teacher
or any other person in the virtual classroom.
• I may not audiotape, videotape, or photograph during the lesson.
• Every child’s right to privacy must be honored. I may not discuss my observations or confidential
information about children in the lesson including specific situations that were observed during the lesson.
• If I have concerns about my child or other students, I should discuss those concerns with the classroom
teacher, therapist, case manager, and/or campus administrator.
To continue to provide your child’s IEP services, the district requests the following release of information and
permission to provide services in a group eLearning or teletherapy environment:
• I acknowledge that it may be necessary for my child to be visible on camera for some eLearning or
eTherapy sessions and could be seen or heard by people at alternate locations
• I agree to the release of confidential information for the purposes of IEP implementation
• I understand and agree to my child’s participation in Group E-Learning, including Teletherapy.
• I have been fully informed in my native language or other mode of communication of all information
relevant to my child’s participation in Group E-Learning, including Teletherapy.
• I understand that the granting of my consent is voluntary and may be revoked at any time. If I revoke my
consent, I understand that the revocation is not retroactive and does not negate an action that has occurred
after my consent was given and before my consent was revoked.
Yes
No
Parent Signature
Date
Please contact your child’s case manager or therapist should you have any questions or need additional information.