Forms → Staff → Educational Services → Authorization for School Psychologists Section 504 Attentional Disorders Assessment
Form number: 270-2a
Audience: Parents/Guardians, School Staff
Last revised: November 2016
Form 270-2a - Authorization for School Psychologists Section 504 Attentional Disorders Assessment
In order for Montgomery County Public Schools (MCPS) to evaluate the student’s eligibility under Section 504 of the Rehabilitation Act of 1973, I give permission to the school psychologist to conduct assessment activities. I give permission to the school community health nurse or school health room technician to contact any medical personnel and to share such information with the school psychologist (when necessary). I understand that in carrying out assessment activities the school psychologist will review the student’s records; will observe the
student; may interview the student, the student’s teacher, or myself; and/or may conduct additional functional or normative assessment activities, as necessary. I understand further that the results of the assessments will be included in a confidential student file that MCPS staff members may access on a need-to-know basis and that I may authorize release of the information to another agency or professional.
Forms require Adobe Acrobat Reader 8 or higher. Get Acrobat