Plan to Learn Educational Consulting Agreement
Plan to Learn is an educational consulting company providing direct tutoring services to students with learning disabilities and consultation to their parents surrounding academic issues. The sole staff member of Plan to Learn is Anna Lynch, a certified teacher in elementary education and special education. She has over 10 years of experience in the field of learning disabilities with a B.S. in Special Education from the University of Virginia. As an educational consultant, Ms. Lynch will make educational recommendations but cannot provide a psychological diagnosis of the student.
Services
Registration Packet – Prior to providing consultation services, a registration packet is sent to the family to provide Ms. Lynch with the needed background information for making recommendations. Included in the packet are: Client profile forms for the parents and the student if he/she is at least 9 years old Educational Consulting Agreement Parent Intake form which includes requests for any previous educational, psychological, speech, and/or occupational therapy evaluations Confidential Release of Records Request form Schedule of fees Academic screening packet to be completed by the child independently at home NC Policies and Practices to Protect the Privacy of your Health Information form (HIPPA) All services described herein are offered subject to Plan to Learn’s review of the returned materials in the Registration Packet and Plan to Learn’s preliminary determination that it is likely to be able to provide effective consulting services. Plan to Learn reserves the right to accept or reject a parent or parents’ request for services in its sole discretion. Plan to Learn provides the following menu of services: Initial Consultation – Once the parent has gathered the information requested, he or she should make an appointment for an initial consultation. During this consultation, the information from the registration packet is discussed as well as any other concerns, and decisions are made as to what other services may be appropriate for the child. Qualitative Assessment – In some cases, the psychological evaluation does not adequately describe the child’s specific learning disability. In this instance, Ms. Lynch needs to perform her own qualitative assessment in order to determine the student’s specific learning difficulties.
Tutoring/Coaching – Individualized tutoring is offered when needed on a weekly basis. Tutoring at Plan to Learn is based on the most current, effective research. FastForWord tutoring – Students who have a documented deficit in phonemic awareness skills can benefit from a specialized software-based intervention called FastForWord produced by Scientific Learning, Inc. This is an intensive intervention requiring 100/minutes per day of learning for 4-8 weeks. Parents may purchase the software license to be used at home or at Plan to Learn. Written Learning Plans – Learning plans are written for students whose parents and teachers are looking for recommendations on how to best work with the student individually and in a group setting. Learning plans include research-based teaching strategies, recommendations for classroom accommodations and assistive technology where indicated. Additional Consultation Services Advocacy – Parents frequently need advice when working with the school to develop an IEP (Individual Education Program) for their child. IEP consultation services are offered in the Plan to Learn office. If requested, Ms. Lynch may attend an IEP meeting to provide direct advocacy services. The parents should note that Ms. Lynch is not an attorney and her recommendations cannot be construed as legal advice. Written and Telephone Communication – Ms. Lynch may need to communicate with the student’s teachers, pediatrician, speech pathologist, occupational therapist, psychologist or other professionals who have evaluated and made recommendations about the child so that there may be a team approach to developing and implementing a learning plan. This communication would only occur with the written permission of the child’s parents/guardian. Confidentiality of Communication Except as otherwise required by law, all records, conversations and personal information concerning your child will be kept strictly confidential and will not be provided to any other party without written consent from the parent/guardian. Please see the NC Notice Form included in the registration packet for further information. Payment The fee schedule for all services is attached on a separate page to this agreement. All fees are to be paid by check payable to Plan to Learn at the time of service, except for on-going, customized tutoring services, which are paid monthly in advance. Invoices for on-going tutoring services will be mailed on or about the 1st of month. All returned checks will be charged an additional $25.00. Clients not showing up for an appointment without notifying the office 24 hours in advance will be expected to pay a missed
appointment fee of $45.00. By signing this agreement, the below-named parents agree to the above-stated payment schedule. Agreement Signing this agreement constitutes a commitment on both the parent and the consultant to provide the stated information for the benefit of educating the child. This agreement contains the entire understanding of the parties, is made in the State of North Carolina and shall be construed in accordance with the laws of that State. The terms of this agreement will apply to all services provided by Plan to Learn and/or Anna Lynch to the below-named parent(s) and his/her/their below-named child unless the parties otherwise agree in writing. Plan to Learn reserves the right, in its sole discretion, to discontinue services to the below-named parent(s) and/or child at any time based upon Plan to Learn’s best judgment as to the effectiveness of Plan to Learn’s consulting services for such persons. Limits of Liability; No Refunds While Plan to Learn will provide its consulting services in a professional manner and based on Ms. Lynch’s best judgment, Plan to Learn does not offer any guaranties or warranties. The parties recognize that each child’s learning styles and requirements are unique and that Plan to Learn does not guarantee that the consulting services to be provided hereunder will result in any particular level of academic success or attainment. To the maximum extent permitted by applicable law, any conditions or warranties imposed or implied by law are hereby excluded, and neither Plan to Learn nor Ms. Lynch shall have any liability for consequential, incidental, special or other indirect damages arising out of or in connection with the services provided hereunder. In no case shall Plan to Learn or Ms. Lynch have any liability for damages alleged to have occurred as a result of or in connection with the services provided hereunder in an amount that exceeds amounts paid to Plan to Learn hereunder. All fees paid hereunder are considered earned upon receipt and are not refundable. If you agree to the terms of this agreement, please print and sign your name(s) and date below and return to Plan to Learn for consultant’s signature. A signed copy with all signatures will be sent to you after review of the completed Registration Packet and Plan to Learn’s acceptance of the below-named child for services. __________________________
Parent Name – please print
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Parent signature with date
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Parent Name – please print
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Parent signature with date
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Anna Lynch, B.S., Consultant
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Date