Parent / Guardian Permission to Observe


Month / Year:

Child's Name:

Date of Birth:

Family Contact Phone Number:

I, , give my permission for the CAPE Head Start's Behavior Specialist and Early Childhood Mental Health Consultant to observe my child while involved in Head Start activities. These observations will take place in the fall and spring.

  • After each observation, the Head Start staff will inform me of the results of the observation and any recommended services.
  • I understand that I may ask to speak with a Mental Health Consultant or Behavior Specialist at any time regarding their observation of my child. Head Start Performance Standards require that our program consult with professionals to help our staff and parents implement strategies to identify and support children's social and emotional behavior and to assist with interventions as needed.
  • We utilize a trained Behavior Specialist or mental health professional to ensure the mental health and social emotional needs of children are being met in the classroom. This professional completes routine observations in classrooms and may discuss specific behaviors and strategies observed during those observations with teachers to, again, ensure we are meeting the needs of all children.
  • Our program partners primarily with Southwestern Behavioral Healthcare, INC. for external referrals, staff and parent consult, and other individual needs for children and families.
  • If a child's behavior becomes an issue with their participation in the program, we will utilize our partnership with Southwestern Behavioral Healthcare. We may also coordinate services if parent/guardian prefers a specific external referral agency.
  • Staff will always work in identifying ways to support the child and family with appropriate interventions.
  • Behavior Specialists or any other mental health consultants will not meet with a child or do a specific child classroom observation/assessment without express written consent from the parent.

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Signature Certificate
Document name: Parent / Guardian Permission to Observe
lock iconUnique Document ID: 2f1271c43b7ff75c84445847e8194c061fa061d0
Timestamp Audit
April 23, 2021 2:49 pm CDTParent / Guardian Permission to Observe Uploaded by Joe Massaro - IP