Service Provider - Little Angels Center
Instructions: This consent form for the use of Telepractice as a service delivery method for the provision of CPSE services must be completed for each service type authorized for the above-referenced student before telepractice services can be initiated. Telepractice as a preschool related service/SEIS delivery method is only available during the declared state of emergency for COVID-19.
A consent form for the use of Telepractice can be returned by email if the parent/guardian also signs and returns the Suffolk County Parental Approval to Use E-mail to Exchange Personally Identifiable Information. The consent form for the use of Telepractice must be signed and returned prior to the initiation of services. A separate consent form is required for each service.