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Authorization for School Psychologists Section 504 Attentional Disorders Assessment

About this Form

Form number: 270-2a

Audience:  Parents/Guardians, School Staff

Last revised: November 2016

Related Forms

Form 270-2 - Section 504 Plan

Form 270-2b - Section 504 Evaluation

Form 270-2c - Section 504 Progress and Accommodation Review Worksheet

Form 270-2D - Distribution of Section 504 Plan

Form 270-2E - Section 504 Causation Meeting Form

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.

Adobe PDF Authorization for School Psychologists Section 504 Attentional Disorders Assessment49 KEnglish
Adobe PDF Autorización a Psicólogos Escolares para Realizar la Evaluación de Sección 504 de Trastornos de Atención74 KSpanish
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Adobe PDF ለትምህርት ቤት የስነ-ልቦና ባለሙያዎች ፈቃድ (ሥልጣን ስለመስጠት) ክፍል (Section) 504 የትኩረታዊ የጤና እክሎች ግምገማ (Attentional Disorders Assessment)53 KAmharic

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