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Permission For Screening of Speech and Occupational Therapies

Your child’s early childhood program has agreed to participate in Foothills Creative Beginnings’ (FCB) Early Intervention Screening to identify possible speech and language, fine or gross motor or regulation concerns. We are seeking your permission to screen your son or daughter. This screen should take no more than 10 – 20 minutes to complete and will help determine if Early Intervention Support services provided by FCB may be recommended for your child. Screening usually occurs during programming me at your child’s school or daycare site. If your child will not be in attendance on the scheduled screening day, please inform your child’s teacher to make arrangements for an alternate me. In order for a child to receive services from FCB, there are minimum number of programming hour requirements.If the screening results indicate your child may benefit from Early Intervention services, you will be contacted by one of FCB’s Early Learning Coordinators (ELC) to review and discuss programming and receive therapist information to book an assessment appointment.

Please note, screening and registration must occur prior to September 29, 2022 in order for children to receive services funded through Alberta Education.

Parent / Guardian

Parent / Guardian Name*
Child's Name*
MM slash DD slash YYYY
Please indicate which days your child attends*
Class Time*
:
I/We give permission for Foothills Creative Beginnings to screen my child in the areas of speech and occupational therapies.*
I understand that Alberta Education requires that my child participates in 475 hours of teacher director instruction for M/M or ELL funding and 400 hours for PUF.*
Date*

If you have any questions or concerns please call 403.300.5543