Fillable Parent Information Letter Template printable pdf download

Parent Information Letter

Dear Parent or Guardian:

This semester our school will participate in the Healthy Kids Colorado Survey (HKCS), an important

research study about student health and risk-related attitudes and behaviors. This letter is coming to you

because your student is enrolled in a class that has been randomly chosen to participate in this voluntary,

anonymous survey. This survey will ask students about various health topics, including: physical activity,

nutrition, alcohol, tobacco, and other drug use, mental health and suicide, bullying and other forms of

violence, and health care. The survey also asks students about school engagement, school climate, youth-

adult connectedness, and other protective factors known to be associated with healthy behaviors.

The HKCS was developed by the Centers for Disease Control and Prevention (CDC) and the Colorado

Departments of Education (CDE), Human Services (CDHS), and Public Health and Environment (CDPHE).

These agencies provide funding to the University of Colorado-Anschutz Medical Campus to implement the

survey. This project has been approved by your school district and the Colorado Multiple Institutional

Review Board (COMIRB). The anonymous survey results will help policy-makers, school personnel and

community groups better understand the nature and extent of risk behaviors among our youth. The results

will also help with planning programs and services for youth, as well as evaluating current programs. In

order to get the most accurate information about youth risk behaviors, we would like all selected students to

take part in the survey. As described below, however, participation in the survey is completely voluntary.

The paper and pencil survey is voluntary and anonymous and takes about 45 minutes to complete in a chosen

classroom. The survey administration process has been designed to protect your student’s privacy. No

information is collected that can identify individual students. Only your child will know how he or she

answers the questions. Students do not get school credit for completing the survey, and there is no penalty for

not participating. Students who take part in the survey may choose not to answer any question.

If your child will participate in the Healthy Kids Colorado Survey, you do not need to sign or return

anything. Students will receive the survey in class and are instructed to answer the questions or leave the

survey blank. Students who are not completing the survey will do other schoolwork at their desk during the

survey period. We encourage you to discuss the matter with your child and share your views on their choice

to participate.

For more information about the study and to view a copy of the survey, please check the front office of your

child’s school or call the Healthy Kids Colorado Survey Director, Dr. Ashley Brooks-Russell, at 303-724-

8437. For questions regarding IRB approval, please contact COMIRB at 303-724-1055.

If your child will participate in the Healthy Kids Colorado Survey, you do not need to return this form. If

your child will NOT participate in the survey, complete this form and have your child return it to the school

in the next two weeks.

Student’s name: _______________________________________ Grade: _________________________

I have read this form and understand what the Healthy Kids Colorado Survey is about.

I do not want my child to complete the survey.

Parent’s Name (printed): _______________________________________________________________

Parent’s signature: _________________________________________________Date: _______________

Parent Information Letter Template