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