IEP Attendance Consent Form

IEP ATTENDANCE CONSENT FORM

This form documents consent for participation in an Individualized Education Program (IEP) meeting for the student named below. Completion of this form authorizes the school district to invite identified participants and to proceed with meeting arrangements consistent with federal and state special education procedural protections.

Student Information

Parent / Guardian or Adult Student Information

Proposed IEP Meeting Details

Proposed Meeting Date:    Start Time:    End Time:

Proposed Participants

Please indicate which of the following are requested to attend. Check all that apply.

Parent / Guardian
Student
Special Education Teacher
General Education Teacher
Related Service Provider (e.g., Speech, OT, PT)
LEA Representative
School Psychologist / Evaluator
Interpreter / Translation Services
Other:

Method of Attendance

Please indicate preferred method(s) for participation (check all that apply).

In Person
Telephone
Phone Number for Call:
Video Conference / Remote
Platform / Access Details:

By checking the box below and signing, I consent to participation by the marked remote method(s) when necessary for the conduct of the IEP meeting and acknowledge that remote participation may limit certain in-person interactions.

I consent to participation by telephone or video conference when applicable.

Privacy, Recording, and Records Release

The following authorizations relate to confidentiality and the limited release or recording of information for the sole purpose of supporting the IEP process. The school will maintain any records in accordance with applicable education records law.

I authorize the release of relevant educational records and evaluation information to invited meeting participants for the purpose of this IEP meeting.

I authorize audio and/or video recording of the IEP meeting for documentation and educational planning purposes.

If recording is authorized, specify any limitations or conditions:

Interpreter / Auxiliary Aids

I request an interpreter or other auxiliary aids/services.

Proxy or Representative Attendance

If you wish to designate another adult to attend the meeting in your place, provide their name and relationship. You retain the right to attend or revoke a proxy at any time prior to the meeting.

Rescheduling / Withdrawal of Consent

You may decline or withdraw consent for any portion of this meeting arrangement or request an alternative date. To request a reschedule, indicate preferred alternate dates or times below. The district will make reasonable efforts to accommodate scheduling needs consistent with timely provision of special education services.

Certification and Consent

By signing below, I affirm that I am the parent, legal guardian, or an adult student with authority to provide consent. I have read and understand the information provided on this form. I consent to the attendance arrangements and authorizations I have indicated above for the purposes of the IEP meeting described herein. I understand that I may revoke this consent in writing prior to the meeting and that revocation does not invalidate actions already taken in reliance on my prior consent.

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