Telehealth Information & Consent Form
During the current COVID-19 emergency school closure period, many special education services are being provided remotely using online platforms or by telephone, including services pursuant to a child’s individualized education program (“IEP”) or Section 504 Plan. These services are referred to as “teletherapy.” Schenectady City School District has approved the use of Googlemeet, Doxy.Me, and the use of a telephone to provide teletherapy services to its students in the most effective way possible.

Teletherapy is only available during the school closure for COVID-19. When school reopens, IEP and Section 504 plan services will once again be provided to your child in the previous manner they are typically provided.

By signing below, you provide your understanding that teletherapy services will be delivered using non-public audio and/or video during the duration of the session. The District will make its best efforts to protect the confidentiality of your child’s educational records while delivering teletherapy.

Your child’s therapist and/or teacher will contact you directly to discuss the teletherapy services that may be used with your child, including the form of services to be delivered (e.g., online, telephone, or other) and the frequency, duration, and ratio of such services. Some students will require the assistance of an adult or other caregiver in the home before and during the teletherapy session to facilitate the student’s ability to access teletherapy.

Some teletherapy sessions will include more than one participating student. Your signature below indicates your understanding that the confidentiality and privacy of all students must be respected when your child participates in teletherapy sessions. There is to be no recording of any sessions.

By completing and submitting this form, I hereby consent to engage in teletherapy with a therapist/interventionist/related services provider in the Schenectady City School District.
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