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Consent for Virtual Occupational
Teletherapy Services

Due to the current COVID-19 Pandemic and in the event that school may be remote, designated agencies that provide Occupational Therapy for students within the Comsewogue School District will be providing virtual occupational therapy services for those students who receive such services.  All providers are committed to providing your son/daughter with the additional support they may need during this unprecedented health situation.

This means that we will be able to provide OT services through digital meetings/sessions via the Google Classroom/Meet format.  The Occupational Therapist and the student would join a computer-based session at a designated therapy time and would work on established goals, just as would take place within the school setting.  This mode of service delivery, when implemented correctly, is noted to have equal outcomes to face-to-face interventions.

to engage in Occupational Teletherapy as delivered by my child’s Occupational Therapist.  I understand that teletherapy includes treatment using interactive audio, video, or data communications.

I understand with respect to Virtual Occupational Therapy that I have the right to withhold or withdraw my consent at any time without affecting future care or treatment.

I understand that I am responsible for:

(1) ensuring access to the necessary computer, telecommunications equipment and internet access for the teletherapy sessions

(2) the information security on my computer

(3) arranging a location with sufficient lighting and privacy that is free from distractions for my child’s virtual occupational therapy session.

We ask all students and family members to be respectful of the privacy interests of other students. As a result, where possible, students participating in group services should attempt to do so from a location which can not be observed by others and utilize headsets.  To the extent that family members observe the delivery of instruction of other students, we ask that you respect the privacy of the other students and not disclose personal information about any student to any third party.

Please note: At this time, your son/daughter may not be participating virtually, however your signature below will indicate your consent for virtual occupational therapy services, in the event that the school district moves to an all “on-line” format due to a COVID-19 school closure. 

Parent/Guardian Signature *