Early ACCESSGuidance Specific to Early ACCESS
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| Demographic information | The release pertains only to the child (or other family member named in the upper right-hand corner) and cannot be used to request information for more than one member of a family. For each member of the family that information is requested, a separate release must be completed. For example, to obtain mental health information on the child's mother, a separate release must be completed listing the mother's name. Please include the name of the Service Coordinator. |
| Evaluation areas needed | Each area of evaluation, the associated discipline, and the agency to do the evaluation needs to be listed. |
| Parental rights | Parental rights and procedural safeguards must be reviewed at this time. The name and agency of the person reviewing the rights with the parents must be documented and dated. |
| Consent | Parents must check to give or refuse permission to evaluate. |
| Expiration of the Consent | Consents are only valid for a maximum of one year. Parents may choose to have the release expire prior to one year. In that event, the expiration date needs to be specified. If a date is not inserted, the consent will automatically expire one year from the date of signature. |
| Copies of the Consent | The original must be sent to the grantee to keep in the official record. A copy of the consent must be given to the family, agencies doing evaluation components, and kept as part of the IFSP record. Please check the appropriate box on the bottom of the form. |
| HIPAA/ FERPA information | Once the health information is received, it becomes part of the child’s “educational record” since Early ACCESS is funded by Individuals with Disabilities Education Act (IDEA). As part of the educational record, it then becomes protected by Family Educational Rights and Privacy Act (FERPA). |
| EA Rules Citations | Citations 281—120.4 Definitions: consent, evaluation, records 281—120.27(3) Consent 281—120.27(4) Evaluation 281—120.42 Maintenance of records 281—120.67(2) Parental consent required |
