№ files_lp_3_process_7_061256
File format: docx
Character count: 1799
File size: 22 KB
School health notification and referral form documenting student hearing screening results, audiometric findings, and recommended follow-up actions within a New York State school setting.
Year:
2018
Month:
May
Region:
New York State
Country:
United States
Subject:
School hearing screening and audiometric referral
Document Type:
School health notification and referral form
Issuing Organization:
NYS Center for School Health
Intended Audience:
Parents/Guardians of students
Related Institution:
School District
Medical Focus:
Hearing screening and audiometric evaluation
Grades Concerned:
Grade 7 and Grade 11
Source Note:
Sample resource created by NYS Center for School Health
Administrative Fields:
Student information, screening results, professional examination report, medical provider signature, school receipt confirmation
Price: 8 / 10 USD
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The product description is provided for reference. Actual content and formatting may differ slightly.
Year:
not specified
Jurisdiction:
Washington State
Subject:
Prison visitation of minors
Document type:
Consent form
Issuing authority:
Washington State Department of Corrections
Related forms:
DOC 20-181 Minor Visitor Application; DOC 21-415 Extended Family Visit Application/Acknowledgment
Legal basis:
Executive Order 16-01; RCW 42.56; RCW 40.14
Notarization requirement:
Required
Target group:
Parents or legal guardians of minors
Confidentiality note:
Social Security Numbers subject to redaction
Distribution:
Original – Imaging file
Note:
Date
Year:
2016
Region / City:
Canada, Vancouver
Topic:
Child Development, Education, Well-being
Document Type:
Informational Letter
Organization:
Human Early Learning Partnership, University of British Columbia
Author:
Kimberly A. Schonert-Reichl, Martin Guhn, Shelley Hymel
Target Audience:
Parents, Guardians, Caregivers
Period of Validity:
Not specified
Approval Date:
October 2016
Amendment Date:
Not specified
Note:
Year
Document Type:
Permission Form
Organ / Institution:
Alateen
Target Audience:
Parents/Guardians
Risk Acknowledgement:
Yes
Phone Numbers Included:
Yes
Year:
2023
Region / City:
United States
Topic:
Teen dating and parent involvement
Document Type:
Consent form
Organization / Institution:
Centers for Disease Control and Prevention
Author:
Division of Violence Prevention, National Center for Injury Prevention and Control
Target Audience:
Parents/Guardians of middle school students
Period of Validity:
Not specified
Approval Date:
Not specified
Date of Changes:
Not specified
Year:
2026
Region / City:
Australia
Topic:
Child & Adolescent Health Research
Document Type:
Consent Form
Organization:
Child & Adolescent Health Service (CAHS)
Author:
Not specified
Target Audience:
Parents / Guardians of children participating in the study
Period of Action:
Not specified
Approval Date:
Not specified
Date of Last Modification:
Not specified
Year:
2023
Region / City:
[Not specified]
Subject:
Alcohol, Tobacco, and Drug Safety in Schools
Document Type:
Survey Consent Form
Author:
[Not specified]
Target Audience:
Parents or guardians of students
Effective Period:
[Not specified]
Approval Date:
[Not specified]
Date of Changes:
[Not specified]
Year:
2022-2023
Region / City:
Winthrop, IA
Theme:
School Meal Application
Document Type:
Information Letter
Author:
East Buchanan Community School District
Target Audience:
Parents/Guardians of Students
Period of Validity:
2022-2023 School Year
Approval Date:
Not specified
Date of Last Update:
Not specified
Year:
2023
Region / City:
Not specified
Topic:
Student Information and Emergency Contacts
Document Type:
Form
Organization / Institution:
Choices Schools
Author:
Ms. Malcolm
Target Audience:
Parents/Guardians of Students
Effective Period:
Not specified
Approval Date:
Not specified
Date of Changes:
Not specified
Year:
Not specified
Region / City:
Not specified
Subject:
Mathematics
Document Type:
Letter
Organization / Institution:
Not specified
Author:
Sean Easton
Target Audience:
Parents/Guardians of students
Action Period:
Not specified
Approval Date:
Not specified
Date of Changes:
Not specified
Contact Information:
Yes
Parent Portal Information:
Yes
Event Date:
Thursday, September 17th, starting at 7pm
Course Details:
Yes
Note:
Year
Contextual description:
Parent/guardian consent form for participation in the Young People Advisory Group, detailing responsibilities, medical requirements, and emergency contact information.
Note:
Year
Theme:
Mountain Biking, Family Dynamics
Document Type:
Interview Guide
Target Audience:
Youth, Parents/Guardians, Researchers
Year:
[Insert Year]
Region / School District:
Fulton County School District
Type of Document:
Consent Form
Target Audience:
Parents, Guardians, and Students Over 18
Purpose:
Permission for child participation in a research study at school
Data Collected:
Student participation details, survey responses, instructional materials review
Legal Compliance:
FERPA, PPRA
Rights Information Provided:
Code of Conduct & Discipline Handbook, District Policy IJ—Program Evaluation
Participation Conditions:
Voluntary, withdrawal allowed at any time, identity protection ensured
Dates of Study:
DD/MM/YEAR to DD/MM/YEAR
Contact Information:
Provided within form for further inquiries
Source Type:
Institutional consent form
Year:
2015
Region / City:
Highlands School District
Subject:
Homeless Assistance for Students
Document Type:
Notification
Institution:
Highlands School District
Author:
Carmen Corna
Target Audience:
Parents/Guardians of children potentially experiencing homelessness
Validity Period:
School Year
Approval Date:
2015
Amendment Date:
Not specified
Year:
2026
Region / City:
Kansas, USA
Topic:
Maternal and Child Health, Substance Use Screening
Document Type:
Model Policy Template
Organization / Agency:
Kansas Department of Health, Bureau of Family Health
Target Audience:
Healthcare providers serving perinatal and postpartum women
Effective Period:
From implementation date, ongoing
Related Materials:
SBIRT Integration Toolkit, ASSIST Screening Tool, Crisis Intervention Algorithm, Consent Forms
Note:
Year
Theme:
Rental Screening
Document Type:
Policy
Organization / Institution:
SG Property Management
Target Audience:
Applicants
Year:
2025
Region / City:
United States
Topic:
Maternity care, Infant nutrition
Document Type:
Survey form
Organization:
Centers for Disease Control and Prevention (CDC)
Author:
Centers for Disease Control and Prevention (CDC)
Target Audience:
Hospital staff, specifically those responsible for infant feeding practices
Period of Action:
January 1, 2025 - December 31, 2025
Approval Date:
Not specified
Amendment Date:
Not specified
Year:
2025
Region / City:
Canberra
Theme:
Clinical risk assessment, Care planning
Document Type:
Procedure
Institution:
Canberra Health Services
Author:
Not specified
Target Audience:
Healthcare professionals at CHS
Period of Validity:
Indefinite
Approval Date:
Not specified
Date of Changes:
Not specified
Year:
2024
Region / city:
Oregon, USA
Subject:
STI Screening, Testing, and Treatment
Document type:
Clinical Practice Standard
Agency:
(insert AGENCY name)
Author:
Centers for Disease Control and Prevention (CDC), Oregon Health Authority (OHA)
Target audience:
Reproductive health MDs, DOs, NDs, PAs, NPs, RNs
Effective date:
January 2024
Revision dates:
January 2018, January 2019, January 2021, October 2022, January 2024
References:
CDC, OHA
Period of validity:
Ongoing
Approval date:
Not specified
Date of changes:
January 2024