School Debrief Consent Form

Please read carefully.

We include a 30 minute online debrief with the Psychologist and your child’s teaching team to review the report with them so that they understand the report and recommendations. Thank you for your cooperation.

Your details

Parent or guardian name*

Parent or guardian email*

Child's full name*

What is your relationship to the child?*

Which school is the child attending?*

I hereby give consent to share the SPOT assessment report as well conduct a 30 minute online debrief with teachers listed from the above mentioned school*

Yes

Teacher details

Please provide details for the main teacher we can contact to coordinate the debrief.*

First name	Surname	Email

Please provide details for any additional teachers we should invite to the debrief meeting.

First name	Surname	Email

Signature

Today's date*

Signature*

Please sign inside the box using either your mouse or finger on a touchscreen device.

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We include a 30 minute online debrief with the Psychologist and your child’s teaching team to review the report with them so that they understand the report and recommendations. Thank you for your cooperation.

Your details

Teacher details

Signature

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