Services including but not limited to communication regarding service delivery, his/her progress and any other related matters. I understand that use of e-mail without encryption presents the risks noted above and may result in an unintended disclosure of such information.
(Optional) In addition, I give permission for members of my child’s treatment team to communicate personally identifiable information concerning my child with each other using unencrypted e-mail. Preschool team members who I give permission to use unencrypted e-mail to communicate with each other about my child include: