• Phone: 813.754.5555
  • Email: info@headsusa.com
  • Fax: 813.754.5552
HEADS
  • Home
  • About us
  • Programs
    • Specialized Therapeutic Foster Care
    • Behavioral Health Therapy
      • Referral Form
      • Primary Care Physician Contact
      • Consent for Treatment
      • Confidential Info Consent
      • School Permission Letter
      • Behavior Checklist
      • Psychiatric Consent
      • Telehealth Consent
      • Confidential Info Release Consent
    • Day Program
      • Psychiatric Consent
      • Referral Form
      • Primary Care Physician Contact
      • Consent for Treatment
      • Confidential Info Consent
      • School Permission Letter
      • Behavior Checklist
      • Off Premises Consent
      • Confidential Info Release Consent
    • Client Handbook
  • Español
    • Terapia de salud conductual
      • Formulario de referencia
      • Contacto con el médico de atención primaria
      • Consentimiento para el tratamiento
      • Consentimiento de información confidencial
      • Carta de permiso escolar
      • Lista de verificación de comportamiento
      • Consentimiento psiquiátrico
      • Consentimiento de telesalud
      • Consentimiento de divulgación de información confidencial
    • Consentimiento De Extensión
    • Consentimiento De Telesalud
    • Consentimiento para Traductor
    • Manual del Cliente
  • Telehealth
  • Extension
  • Disaster Plans
  • Careers
  • Contact us

School Permission Letter

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  • To Whom It May Concern,
  • attends your school. He/She is currently receiving therapeutic services from a contracted therapist with Healing Educational Alternatives for Deserving Students, LLC (HEADS). These services have been deemed appropriate and necessary in keeping with the mandate of the referral and the intention of the State of Florida. It is critical that you allow these clinical interventions to occur for this child so that this student may receive the support needed and reach his/her goals. The HEADS team will work in conjunction with you and your staff to be the least disruptive to the school day.
  • Below is the consent from the student’s legal guardian:
  • I hereby give my permission for HEADS staff/therapist to see my child,
  • at their school for the purpose of counseling/therapeutic intervention during the
  • School Year
  • Date Format: MM slash DD slash YYYY

We want every client
to achieve their highest potential

  • Contact us
  • Call us today813.754.5555
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Contact

Email: info@headsusa.com
Phone: 813.754.5555
Fax: 813.754.5552

 

Locations

Corporate Office
1001 East Baker Street
Suite 100
Plant City, Florida 33563

Fort Myers
3049 Cleveland Avenue
Suite 290
Fort Myers, Florida 33901

Orlando
5749 Westgate Drive
Suite 200
Orlando, Florida 32853

Wildwood
901 Industrial Drive
Suite 200
Wildwood, Florida 34785

Privacy Policy
Política de privacidad

Copyright © 2021 - HEADS All rights reserved.
HEADS is an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status.
It is the policy of HEADS to comply with the requirements set forth in the Americans with Disabilities Act, Section 504 of the Rehabilitation Act as well as other applicable local and state regulations. For special accommodations or to request materials in accessible format, please contact us at (813)754-5555. If you are hearing or speech impaired please use the Florida Relay Service 1-(800) 955-8770 (Voice) or 1-(800) 955-8771 (TTY).
  • Home
  • About us
  • Programs
    • Specialized Therapeutic Foster Care
    • Behavioral Health Therapy
      • Referral Form
      • Primary Care Physician Contact
      • Consent for Treatment
      • Confidential Info Consent
      • School Permission Letter
      • Behavior Checklist
      • Psychiatric Consent
      • Telehealth Consent
      • Confidential Info Release Consent
    • Day Program
      • Psychiatric Consent
      • Referral Form
      • Primary Care Physician Contact
      • Consent for Treatment
      • Confidential Info Consent
      • School Permission Letter
      • Behavior Checklist
      • Off Premises Consent
      • Confidential Info Release Consent
    • Client Handbook
  • Español
    • Terapia de salud conductual
      • Formulario de referencia
      • Contacto con el médico de atención primaria
      • Consentimiento para el tratamiento
      • Consentimiento de información confidencial
      • Carta de permiso escolar
      • Lista de verificación de comportamiento
      • Consentimiento psiquiátrico
      • Consentimiento de telesalud
      • Consentimiento de divulgación de información confidencial
    • Consentimiento De Extensión
    • Consentimiento De Telesalud
    • Consentimiento para Traductor
    • Manual del Cliente
  • Telehealth
  • Extension
  • Disaster Plans
  • Careers
  • Contact us