Confidentality/communication Agreement For Non-Sbcsc Employees printable pdf download

South Bend Community School Corporation

Phone: 574-283-8130 Fax: 574-283-8105

CONFIDENTIALITY/COMMUNICATION AGREEMENT

FOR NON-SBCSC EMPLOYEES

Recognizing the need for school based and home based teams to work together effectively, this

protocol aims to facilitate communication and partnership between school staff and outside

therapists/consultants.

This protocol addresses ways of working together to combine the various unique perspectives,

understandings and skills to accomplish goals that might not be achieved independently.

Under this protocol, professionals will share information and agree upon a communication plan to

address questions and issues that might arise regarding the progress of a student with special needs.

Since the classroom teacher is generally an active participant in the school based program of a

student with special needs, the classroom teacher(s) should be an integral part of the process. The

following guidelines are offered to clarify roles and responsibilities and to maximize the benefits to the

student.

1. Outside professionals who wish to liaise with school staff and/or observe a student, must contact

the respective district support team who will facilitate the scheduling of the pre-observation

meeting. The purpose of this initial meeting is to review, and sign this protocol agreement prior to

non-SBCSC staff involvement.

2. Parents must give written permission for outside professionals to participate in any activities at

school, including but not limited to observations, meetings, etc. This protocol agreement records

how services will be communicated in accordance with the student’s educational goals as

outlined in the Individual Education Plan (IEP) including the Behavioral Intervention Plan (BIP).

3. Non-SBCSC staff visiting classrooms and/or schools in the South Bend Community

School Corporation must be respectful of the confidential nature of all discussions as well

as respectful of privileged, confidential information gained through meetings or general

access in the school. SBCSC retains the right to discontinue this partnership at any time.

4. All verbal and written communication between parents, teachers, district staff and outside

personnel is to be shared respectfully at a place and time that is suitable to all involved.

Furthermore, other students are not to be identified or named in reports, observation notes, or in

verbal discussion.

5. Prior to visiting a classroom, every non-SBCSC employee must have or submit proof of a

criminal history background check. Individuals who do not have a recent criminal history

check must contact the Human Resources Department for SBCSC and request a limited

criminal history check. There is no cost for the limited history check.

[Copies: Parent, Cum, TOR, Outside Therapist/Consultant, Special Education Dept

8/07/2015

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Confidentality/communication Agreement For Non-Sbcsc Employees