Child Educational Assessment Consent Form

Child's Information

Child's Full Name Date of Birth School Name Grade

Parent/Guardian Information

Parent/Guardian Name Relationship to Child Contact Number Email Address

Assessment Details

Assessment Provider/Organization Type of Assessment Reason for Assessment

Consent

I hereby give my consent for the above-named child to participate in the described educational assessment. I understand the purpose and procedures of the assessment and authorize the provider to conduct it.

Additional Comments/Notes