Child Name - First and Last (required)
Child's Code (required)
Parent's Name - First and Last (required)
Your Email (required)
Please check either "YES" or "NO" to the following statements:
YES, I grant permission for any of my child’s behavior technicians and for my child’s BCBA to take off their KN95 mask, and to wear only a face shield, when implementing certain procedures and tasks that require my child to see the behavior technician’s or BCBA’s face or mouth (as deemed necessary by my child’s BCBA, in order for my child to meet target objectives or goals).
NO, I do not want my child’s behavior technicians or BCBA to take off their KN95 mask for any reason.
I understand that I can decide to change my decision regarding this issue at any time. In that case, I will complete this form again and resubmit it. (required) YES, I Understand
Additional Information:
Δ
Click Here For Our Stories!
