This article will help users with the form.
Form information
The Prior Written Notice - Additional Data appears in the Initial Joint Review/Consent and Reevaluation events. It is used in conjunction with the Areas to be Assessed to obtain consent for assessment from the parent, guardian or student at least 18 years of age.
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The additional consent forms, PWN-Add'l Data (initial eligibility event) and PWN-Add’l Data-2 (reevaluation event) along with the Areas to be Assessed forms are available if it is determined that additional areas need to be assessed during the evaluation process. They should only be used after the first PWN-Additional Data has been used. (For an initial evaluation, the first PWN-Additional Data is in the Initial Joint Review/Consent event.) |
Enter method of provision to parent
Enter 1st Date Sent or Given
Select Initial Evaluation or Reevaluation
Select the areas to be assessed
Enter Options considered and why rejected
Enter what the action was based on
Enter Other relevant factors considered
Enter contact information
Save
Consent Section for an Initial Evaluation
Consent Received (Initial Evaluation)
When the PWN is returned with signature for consent, check the Consent box and type in the Parent/Guardian Signature
Enter the Date Signed
Enter the Date Received by the Evaluation Chair
Save
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Send original, signed Prior Written Notice to Word Processing with Initial Referral file when evaluation is completed. |
Consent Refused (Initial Evaluation)
If the PWN is returned with signature indicating consent for assessment is refused or the parent indicates in another way they are refusing to give consent, check the Refused box on the form and type in the parent signature if parent signed the form. If the parent did not return the PWN but indicated they are refusing the evaluation, check Refused and type “Parent Refused” on parent signature line.
Enter the Date Signed or the date the parent indicated they are refusing the evaluation.
Enter the Date Received by the Evaluation Chair.
Save
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If parent refused consent, after locking the Initial Joint Review/Consent Event, Phoenix will create an Exit Event to be completed by the Evaluation Chair. |
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Send original signed Prior Written Notice to Word Processing with Initial Referral file. |
No Response/Final Attempt (Initial Evaluation)
After sending initial attempt to obtain consent, wait 10 days for a response. If no response, issue a second Notice.
Open Prior Written Notice form and enter date in 2nd Date Sent or Given.
Save
Print
Send to Educational Decision Maker (EDM) along with Areas to be Assessed Form
If second PWN is not returned, contact parent.
Confer with school to determine if case will be dropped or more attempts to obtain consent will be made. If more attempts, repeat step 1 using 3rd Date Sent or Given.
When the team has determined that no further attempts will be made, mark No Response and Final Attempt on Prior Written Notice.
Type No Response on signature line.
Enter the date decision was made that case will be dropped in Date Signed and Date Received fields.
Save
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When there is no response for consent for initial assessment and decision is made to drop the referral and the event is locked, Phoenix will generate an Exit event to be completed by the Evaluation Chair. |
Consent Section for a Reevaluation
Consent Received (Reevaluation)
When PWN is returned with signature for consent, check the consent box and type in the parent signature.
Enter date parent signed consent form
Enter date consent form was received
Save
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Send original, signed Prior Written Notice to Student Records when reevaluation is completed. |
Consent Refused (Reevaluation)
If PWN is returned with signature indicating consent for assessment is refused, or the parent indicates in another way they are refusing to give consent, check the Refused box on the form and type in the parent signature if parent signed the form. If the parent did not return the PWN but indicated they are refusing the evaluation, check Refused and type “Parent Refused” on parent signature line.
Enter date parent signed form or indicated that refusing the evaluation.
Enter date Evaluation Chair received notice from parent.
Save
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When a parent refuses consent for a Reevaluation, the reevaluation becomes a reevaluation without assessment. Please refer to the following document: EDM Refusal to Consent or Rescission of Consent to Evaluate |
No Response/Consent Assumed (Reevaluation)
Mark Consent on Prior Written Notice.
Type “Consent Assumed” in parent signature line.
Enter the date the decision was made that consent will be assumed in the date signed and date received fields.
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In a Reevaluation with assessment, if the parent does not respond to two attempts by the public agency to provide prior written Prior Written Notices for intent to Reevaluate, the public agency can proceed with reevaluation after the second 10 day waiting period if the parents do not file for due process. This does not apply to students receiving services through SNAP. For those students, signed consent must be received before proceeding with a reevaluation with assessment. |
Rescission of Consent
Educational decision makers of students referred for an initial special education evaluation or reevaluation have the right to refuse to provide consent for evaluation or rescind their consent at any time during the evaluation process.
Educational decision makers may rescind their consent after signing the PWN giving their consent to test (verbal or written). The RED meeting must still be convened and a PWN provided even when the educational decision maker disagrees with the initial referral for evaluation.
For further information please refer to the following document: EDM Refusal/Rescission.
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