Parental Consent to Screen and/or Assess Form

Your agreement of this screening and/or assessment is acknowledged by signing this parental consent form. Your signature indicates:

• I consent to the participation of my child in a screening and/or assessment of their speech-language (ex: speech sounds, expressive language, etc.) skills.
• I understand that assessment results may be shared with preschool staff and Pathways working partners as it pertains to my child’s programming.