Confidentiality Statement for Online Observations
Parents and Teachers supervising students
Name
*
First Name
Last Name
Class observing
*
Class Start Date
-
Month
-
Day
Year
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Purpose of observing
*
I understand that Federal Regulations on Confidentiality require that I not reveal the identity of any person I may see or discuss while visiting in this classroom. I understand that any disclosure of student information without specific written consent from their parent, or description of any person, may be interpreted as a breach of the Federal Right to Privacy Act.
Signature
*
Clear
Date
*
-
Month
-
Day
Year
Date Picker Icon
Please contact us at arcticvision2020@gmail.com if you have any questions.
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