Hart County Schools

HART COUNTY SCHOOLS

25 Quality Street

MUNFORDVILLE, KY 42765

Dear Parent:

Your child's teacher has asked for my assistance in determining ways to help improve his/her classroom performance. As part of this assistance, I would like to observe your child and administer brief screening tests in areas of difficulty such as reading and math. The results of the screening will be used to help plan strategies for helping your child.

Please sign the bottom of this form in order to give permission for the screening. You may return it by sending it with your child to the teacher or mailing it to the school. If you have any questions, please call me at 524-9345.

Sincerely,

LeAnn Pinson, Ed.S., NCSP

Kristina Sidebottom, Ed.S., NCSP

School Psychologists

______

I give permission for the school psychologist to administer screening tests to my child.

______DOB: ______TEACHER:______

______

Parent's Signature Date