Sending A Letter With A Signed Evaluation Consent Form

I am having Chloe tested at school. I sent this letter noted below along with A Signed Evaluation Consent Form. It is important to let the school department know any information that may help them during a staff meeting on your child. You'll need to change the letter to fit your child's needs. Please keep in mind, that this letter was written for my daughter. I thought it would help parents if they need it (as an example only). As you all know, there is not enough information out there for parents with children who have Heterotaxy Syndrome – Polysplenia.

Put the date

Name of Person
Title
Name of the school
City, State Zip Code

Dear Ms. or Mr. ,

As you know, I had requested that my (Son or daughter), (Child’s Name), be evaluated for special education services. I am concerned about (Child’s Name) performance and progress in school and believe she may need special services in order to learn. (Child’s Name) pre-school (Name of former pre-school) mentioned a concern to me last year. (Child’s Name) ENT specialist at (hospital or practice’s name) also stated that she may have a speech problem. (She or He) called it Articulation. (Child’s Name) Genetics doctor also recommend that I have her evaluated by a Developmental Pediatrician. However, there is a (length if there is one) waiting list. Therefore, I would like the school department to test (her or him) for any learning disabilities that (she or he) may have. I would also like to know what type of testing you will be doing on her so I can let her specialists know. I would also like copies of everything. Please send the copies to me 2 days before we have our meeting.

(Child’s Name) has a syndrome called Heterotaxy Syndrome – Polysplenia with Functional Asplenia. Therefore, (Child’s Name) may be out of school a lot because of illness. I will also keep Chloe home if there is an epidemic at school. My concern is that (he or she) will fall behind in (his or her) school work.

Specifically, I am concerned because (Child’s Name) has trouble following along. (Child’s Name) has a hard time following directions at home. I am very concerned with (him or her) not being able to recognize the alphabet letters and not being able to count past 10. (Child’s Name) also has a hard time writing letters and numbers. (She or He) has a tendency to write her 4’s backwards. (Child’s Name) also gives up to easily and walks away from us trying to teach (her or him) numbers and Alpha letters. We can not hold (Child’s Name) attention very long.

(Child’s Name) tends to exhibits many symptoms of anxiety. I believe this arises from all the treatments, doctors’ visits and studies she has had throughout the years.

I understand that a determination must be made about the information needed and assessment tools to be used for my child's evaluation and that I must give written permission in order for (him or her) to be evaluated. I look forward to discussing the out come of the testing with the appropriate school staff at the earliest opportunity so if needed we can start (Child’s Name) on an IEP. Thank you for your prompt attention to my request.

Sincerely,

You sign in this box

(example) Mrs. Pinky Smith

Enclosure: Signed Evaluation Consent Form