New Haven Youth & Family Services

Student IEP Rights


Youth Name: ____________________________________

Date of Birth: ____________________

New Haven School shall ensure, at the pupil’s discretion, that all communication between a pupil of New Haven School and any member of the pupil’s Individualized Education Plan team be private and confidential, except where specifically limited by applicable confidentiality laws and regulations.  Please review New Haven’s confidentiality and privacy statement for specific exceptions.

I understand my rights in an Individualized Education Plan as listed and described above.


_____________________________________/ __________________

Signature of Student / Date


_____________________________________/ __________________

Signature of Parent, Guardian, or Authorized Representative / Date


_____________________________________/ __________________

Signature of NHYFS Representative or Witness / Date