SAMPLE LETTER OF CONSENT FOR INITIAL EVALUATION

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Sample Parental Notification Letters Gifted and Talented Programs Paul G. Pastorek State Superintendent of Education July 2007 Revised State Board of Elementary and Secondary Education Ms. Linda Johnson President 8th BESE District Mr. Walter Lee 4th BESE District Ms. Leslie Jacobs Vice President Member-at-Large Dr. James Stafford 5th BESE District Mr. Dale Bayard Secretary-Treasurer 7th BESE District Ms. Polly Broussard 6th BESE District Ms. Penny Dastugue 1st BESE District Mr. Edgar Chase Member-at-Large Ms. Louella Givens 2nd BESE District Ms. Mary Washington Member-at-Large Ms. Glenny Lee Buquet 3rd BESE District Ms. Weegie Peabody Executive Director For further information, contact: Dr. Susan A. Aysenne, Director Division of Educational Improvement and Assistance P.O. Box 94064 Baton Rouge, LA 70804 225-342-3513 The Louisiana Department of Education (LDE) does not discriminate on the basis of sex in any of the education programs or activities that it operates, including employment and admission related to such programs and activities. The LDE is required by Title IX of the Education Amendments of 1972 (Title IX) and its implementing regulations not to engage in such discrimination. LDE’s Title IX Coord. is Patrick Weaver, Deputy Undersecretary, LDE, Exec. Office of the Supt.; PO Box 94064, Baton Rouge, LA 70804-9064; 877-4532721 or customerservice@la.gov. All inquiries pertaining to LDE’s policy prohibiting discrimination based on sex or to the requirements of Title IX and its implementing regulations can be directed to Patrick Weaver or to the USDE, Asst. Sec. for Civil Rights. Web-Only Document ii For Use With Gifted and Talented Programs SAMPLE PARENT NOTIFICATION LETTERS TABLE OF CONTENT PARENTAL CONSENT FOR INITIAL EVALUATION...................................2 PERMISSION TO CONDUCT AN INITIAL EVALUATION ..........................4 PARENTAL NOTIFICATION BY THE LOCAL SCHOOL SYSTEM ...........5 AGE OF MAJORITY LETTER TO STUDENT .................................................9 AGE OF MAJORITY LETTER TO PARENT ..................................................10 PARENTAL CONSENT FOR INITIAL EVALUATION Date: School: To the Parent(s)/Guardian(s) of : Results of preliminary educational screening indicate that an individual evaluation would help us determine whether (Student’s Name) is a child with an exceptionality. The information obtained from the evaluation will be used to determine whether extra help under federal and state laws is available. However, your permission is required to begin the evaluation process (see attached Permission page). Once your written permission is received, the evaluation will begin and must be completed within sixty (60) business days. You may withdraw your permission for the evaluation at any point during the process. A qualified professional will assess (Student’s Name)’s educational performance. The evaluation will include, at a minimum, the items checked below:       Vision and/or Hearing Screening, if not previously conducted. A review and analysis of all screening information, which includes school attendance, educational history, social history, and medical history. Interviews with the student, the family, and teachers (if in school). Observations of the student during daily activities: in the classroom, on the playground, at lunch, etc. Curriculum-based assessment to determine the most effective instructional level for the student. Behavioral or instructional interventions which are designed to determine if sufficient improvement can be made in the student’s behavior or academic progress in the regular education program. Appropriate tests which are designed to measure different types of abilities may include individually administered tests of general knowledge and/or academic ability. Speech and language assessment. Functional behavior assessment. Medical assessment. Motor assessment. Other assessments, if needed during the course of the evaluation.       2 For Use With Gifted and Talented Programs Page 2 of 3 If you would like to have additional information considered in the evaluation process, please notify the person named below or write your request on the permission form. Upon completion of the administration of assessments and other evaluation materials as noted above, you will be invited to a meeting to discuss the findings and determine if (Student’s Name) is a child with an exceptionality. A copy of the evaluation results and the determination of eligibility will be provided to you after the meeting. You are strongly encouraged to participate in meetings at which decisions will be made about your child’s educational needs. As a participant, you will be involved in setting the time and date of each meeting as well as who will be in attendance. Parents of a child with an exceptionality have rights, called procedural safeguards, under the Regulations for Implementation of the Children with Exceptionalities Act, Subpart B. Parental rights are described in the enclosed copy of Louisiana’s Educational Rights of Gifted/Talented Children in Public Schools. If you have any questions during the course of the evaluation, please contact: Name: Title: Telephone No: Sincerely, Enclosure 3 For Use With Gifted and Talented Programs Page 3 of 3 PERMISSION TO CONDUCT AN INITIAL INDIVIDUAL EVALUATION Date: School: To the Parent(s)/Guardian(s) of : Please check the appropriate statements and return this form to school as soon as possible to: Name: School:   I give permission for you to conduct an individual evaluation of my child, (Student’s Name). I would like you to consider the additional information listed below in the evaluation process. (List name or describe the additional tests/information.)   I refuse to give permission for you to conduct an individual evaluation of my child, (Student’s Name). I have received a copy of Louisiana’s Educational Rights of Gifted/Talented Children in Public Schools. Signature of Parent(s)/Guardian(s) Date____________________ Date form received by the school system: _________________________________ 4 For Use With Gifted and Talented Programs PARENTAL NOTIFICATION LETTERS BY THE LOCAL SCHOOL SYSTEM Date: School: To (Student’s Name) : : Contact Name: Telephone No.: To the Parent(s)/Guardian(s) of Parents of a child with an exceptionality have legal rights, called procedural safeguards, which are part of the Regulations for Implementation of the Children with Exceptionalities Act. The procedural safeguards are found in the enclosed copy of Louisiana’s Educational Rights of Gifted/Talented Children in Public Schools. If you are a person with a disability or speak another language these rights can be given to you in a different format or language (e.g., Larger print, Braille, on CD, DVD or tape, or translated into another language). It is important that families be fully informed so that they can participate equally in making decisions about their child’s special education. The following arrangements have been made for the meeting: Date: Time: Location: This letter of notification is for you to attend a meeting to:  Discuss the results of the evaluation and documentation of the determination of eligibility.  Develop, review, or amend an individualized education program (IEP) and to determine placement (i.e., services and support, not the building or classroom) for your child. The development of the IEP will be based on information from a variety of sources, including the strengths of the child, the concerns of the parents for enhancing the education of their child, the results of the initial or most recent evaluation of the child, the academic, developmental, and functional needs of the child, and any other special factors. At this meeting we will have a draft copy of the IEP for the Team to review. In all cases, the IEP Team, of which you will be an equal participant, must review each section of the IEP to assure agreement. Any section of the IEP can be revised by the Team before the IEP is finalized. 5 For Use With Gifted and Talented Programs Page 2 of 4  Reevaluate your child’s need for special education services. Your permission is requested for the reevaluation. The evaluation procedures we plan to use include the following:       A review of vision and hearing screening results. A review of existing evaluation data, including evaluations and information provided by you. A review of your child’s progress toward meeting annual goals. Interview with you, your child, your child’s teacher(s) and related services provider(s). A review of current classroom-based assessments and observations in appropriate settings. Other tests and evaluation procedures that the IEP team decides are necessary. 6 For Use With Gifted and Talented Programs Page 3 of 4  Your child will be invited to participate in the IEP Team meeting unless you disagree (if your child is under age of majority 18). You may also bring other person(s) with you to assist in planning the IEP. The following persons listed below will be invited to attend this meeting: School System Personnel: Officially Designated Representative Regular Education Teacher Evaluation Representative Special Education Teacher Other ____________________________________ Other Other Other Excusal Request We are asking permission to excuse the following persons from the meeting: (name and position) (name and position) (name and position) (name and position) (name and position) (name and position)   This member’s area of curriculum or related services is not being discussed at the meeting. This member’s area of curriculum or related services will be discussed at the meeting. Included is the member’s input to the general student information, academic and functional performance levels and goal(s), amount of services, and any other recommendations for your child. Please return the attached sheet to indicate whether you plan to attend the IEP Team meeting as scheduled. If this date, time, or location is not convenient for you, please indicate when you can attend. Return the attached form within three (3) days. 7 For Use With Gifted and Talented Programs Page 4 of 4 Student’s Name: Please check the appropriate spaces, sign and return to the school within three (3) days to: Name: School: Pertains to your child: Applicable I have received a copy of Louisiana’s Educational Rights of Gifted/Talented Children in Public Schools. Note: Parent(s)/guardian(s) of a child with an exceptionality should receive a copy annually, as well as (1) the first time the child is referred for evaluation; (2) the first time a complaint is filed; (3) whenever a parent asks. I have received a copy of the evaluation report and documentation of the determination of eligibility. I give permission for you to conduct the reevaluation and any additional tests that may be needed. I plan to attend the IEP Team meeting at the time and place indicated in the notification letter. I plan to bring _____ additional person(s) with me. I am unable to attend the IEP Team meeting at the time and place indicated in the notification letter. The best day and time for me are: __________ _____________. I am unable to attend the IEP Team meeting scheduled, in person, but I would still like to participate by telephone conference. Please call me at (___) ___-_____ at the date and time specified. Give permission for you to excuse the attendance of the IEP participants as noted on page 3. If you have any special needs, please indicate them here: Parent(s)/Guardian(s) Signature Date 8 For Use With Gifted and Talented Programs AGE OF MAJORITY LETTER TO STUDENT Date: School: (Student’s Name) To : Immediately upon your eighteenth birthday, you will reach the age of majority in Louisiana. In accordance with provisions of Bulletin 1706: Regulations for Implementation of the Children with Exceptionalities Act, Subpart B, when an individual with an exceptionality reaches the age of majority and has not been determined to be incompetent, the local education agency shall give any notice required by Bulletin 1706 to both the individual and his or her parents. All other rights, however, under Bulletin 1706, transfer to the individual. In the past your parent(s)/guardian(s) represented you and helped plan for your special educational needs. While your parents may still attend meetings and help with planning for your education, the rights that they had under law as your parents are now your rights. If you need further information about the transfer of parental rights, you may contact: Contact Name: Title: Telephone No.: 9 For Use With Gifted and Talented Programs AGE OF MAJORITY LETTER TO PARENT Date: School: (Student’s Name) To the Parent(s)/Guardian(s) of : Immediately upon (Student’s Name) ’s eighteenth birthday, he/she will reach the age of majority in Louisiana. In accordance with provisions of Bulletin 1706: Regulations for Implementation of the Children with Exceptionalities Act, Subpart B, when an individual with an exceptionality reaches the age of majority and has not been determined to be incompetent, the local education agency shall provide any notice required by Bulletin 1706 to both the individual and his or her parent(s)/guardian(s). All other rights, however, under Bulletin 1706, transfer to the individual. The rights that were yours to support and plan for your child’s education will transfer to your child who is now legally an adult. While you can still participate in your child’s IEP meetings, notices must now also go to your child who is the student with an exceptionality. If you need further information about the transfer of parental rights, you may contact: Contact Name: Title: Telephone No.: 10 For Use With Gifted and Talented Programs

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