As a student at The Laradon School, your child is eligible to receive a range of services that may include assessment, treatment planning, behavior management, and individual therapy.

The type and extent of services provided will be determined after an initial assessment and through discussions with the student and legal custodian. Treatment will be provided over the course of the student's attendance at Laradon.

A treatment team under the supervision of certified Laradon employees will provide these services. The student will be subject to initial and ongoing assessments, including but not limited to emotional, intellectual, educational, and vocational testing.

Information gathered is confidential except when release is required in cases of medical emergency, homicidal or suicidal ideation, suspected mistreatment, abuse, neglect or exploitation, court order, billing or audit requirements, or whenever otherwise required by law.

Records will be maintained as required by the Colorado Department of Human Services, Division of Child Care Licensing, and applicable state and federal law. Questions may be directed to the student's Treatment Coordinator.

In the event of an emergency, I authorize Laradon to provide first aid and/or CPR and to obtain emergency medical care for my child.

If emergency hospitalization or treatment is required, I authorize Laradon to arrange transportation by ambulance or other emergency medical transportation to an appropriate medical facility.

Laradon will make reasonable efforts to contact the parent/legal guardian or other authorized individual as soon as possible regarding the emergency and any treatment provided.

I understand that I am responsible for expenses associated with emergency medical care, including ambulance transportation, hospitalization, physician services, medications, and other related treatment.

One of the goals of your student's program is to teach new and more socially appropriate behavior. Laradon staff focus on teaching social skills, anger management, conflict resolution, and impulse control.

Physical management may be used in an emergency when a student cannot be stopped from injuring themselves or others in a less restrictive way.

Physical management means the physical action of placing one's hand on an individual to gain physical control and protect the individual or others from imminent harm, after less restrictive interventions have failed. It is used only in emergencies.

1. Physical management is used only to protect the student, or others, from a serious, probable threat of bodily harm.
2. It is used only after other interventions have been tried and found ineffective for the specific crisis.
3. Only staff trained in Safety Care techniques will administer physical management.
4. The student will be released within fifteen (15) minutes of the initiation of physical management, except where precluded for safety reasons, consistent with Colorado licensing regulations.
5. Every effort will be made to help the student regain self-control.
6. The legal custodian will be notified no later than the end of the school day that physical management was used, and a written report will follow by the close of the next business day, consistent with state notification requirements.
7. Each incident of physical management is reviewed. The legal custodian, or Laradon, may request a meeting to determine whether supplementary aids and services identified in the IEP are being provided, are appropriate, or whether the behavior plan needs revision.

Every child has the right to:

1. Enjoy freedom of thought, conscience, cultural and ethnic practices, and religion.
2. A reasonable degree of privacy.
3. Have their opinions heard and considered, to the greatest degree and extent possible, when decisions are made affecting their life.
4. Receive appropriate and reasonable adult guidance, support, and supervision.
5. Be free from physical abuse or neglect and inhumane treatment, and be protected from all forms of sexual exploitation.
6. Receive adequate and appropriate medical care while under Laradon supervision.
7. Receive adequate and appropriate food, clothing, and housing.
8. Live in clean, safe surroundings.
9. Participate in an educational program that will maximize their potential in accordance with existing law.
10. Communicate with significant others outside the facility, such as a legal custodian, caseworker, attorney or guardian-ad-litem, current therapist, physician, religious advisor, and, if appropriate, probation officer.
11. Receive and send sealed correspondence. No incoming or outgoing correspondence shall be opened, delayed, held, or censored by Laradon personnel.

The following rights may be limited to reasonable periods during the day:

1. Access to letter-writing materials, including postage, and staff assistance if unable to write, prepare, and mail correspondence.
2. Access to telephones to both make and receive calls in privacy.
3. Convenient opportunities to meet with visitors.
4. The right to wear their own clothing, keep and use their own personal possessions, and spend a reasonable sum of their own money.

All information pertaining to students is confidential and will not be released without the written consent of the legal custodian or the student.

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOUR STUDENT MAY BE USED AND DISCLOSED, AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

Laradon is required by the Health Insurance Portability and Accountability Act (HIPAA) of 1996 to preserve your confidentiality. Questions about this notice may be directed to School Administration at 303-296-2400.

1. How Laradon Maintains Your Information

Laradon maintains information about you in a secured main file and a secured program-area working file. Both are secure, with limited access.

2. How Laradon May Use or Disclose Your Information

• Treatment – to coordinate and manage your care with doctors and other applicable personnel.
• Payment – when paying or billing for services.
• Health Care Operations – to run and maintain a quality program, including internal surveys and work with contracted Business Associates.
• Communications – with a third party acting on your behalf, excluding communicable disease, drug/alcohol treatment, or mental health records.
• Required by Law – to public health authorities, regulatory agencies, courts, law enforcement, coroners, correctional institutions, specialized government functions, and workers' compensation purposes, as required by law.
• De-identified information may be used to complete analysis of services and populations.

3. Written Permission to Use/Disclose Your Information

For any purpose not listed above, Laradon will obtain written authorization before using or sharing your information. You may revoke authorization in writing at any time; this will not affect any disclosure already made based on a valid authorization.

4. Rights Regarding Your Information

• Request restrictions on certain uses and disclosures.
• Limit disclosure to family, friends, or others involved in your care.
• Inspect and obtain a copy of your information, except psychotherapy notes or records compiled for civil/criminal proceedings.
• Request that Laradon amend information it created that is incorrect or incomplete.
• Receive an accounting of certain disclosures for the six years prior to your request, excluding treatment, payment, and operations disclosures.
• Request confidential communications in a specific way or location.
• Receive a paper copy of this notice at any time.

5. Laradon's Right to Change This Notice

Laradon reserves the right to revise this notice for all information received. The current notice is posted at Laradon and on its website and is provided annually.

6. Complaints

Complaints regarding privacy rights may be submitted in writing to Laradon's Director of Quality Assurance and Strategic Projects or to the U.S. Department of Health and Human Services.

Release Authorization

This consent is valid for one year from today's date unless otherwise indicated. Photographs, video, and audio used for hard copy publication, website, social media, or other marketing campaigns may be used for an extended period.

Information received under this request may not be given to a third party without a separate release form.

This consent may be withdrawn in writing at any time.

Please download the form below and provide it to your student's physician. Once the form has been completed and signed, return here to upload it.

Laradon will ensure students have access to sunscreen when needed on school property or during school-sponsored activities.

Sunscreen is available for activities that expose students to the sun for 30 minutes or more. Laradon uses sunscreen intended for sensitive skin with SPF 30 or higher.

Parents/guardians may also send personal sunscreen. Personal sunscreen should be a new, unopened bottle labeled with the student's initials.

Questions may be directed to the School Nurse.

Activity: Swimming or Splash Pad

Destination: Denver Recreation Center Pools

Your student is eligible to participate in this school activity under the guidance and supervision of Laradon employees.

By consenting to participation, you understand that this activity will take place away from Laradon's campus under the supervision of Laradon employees. Permission also includes the application of sunscreen as needed.

Please indicate your student's swimming ability and participation preference below.

The Laradon School provides students with opportunities to participate in activities in the community, including outings to museums, vocational training opportunities, and nonprofit volunteer work.

Laradon takes reasonable measures to ensure student safety during community-based activities. Students are supervised by Laradon personnel and will receive assistance with appropriate clothing and sunscreen as needed.

Transportation for these activities is provided in a Laradon vehicle.

Student Pick-Up

The Laradon School's hours are 8:30 a.m.–3:00 p.m. on full school days and 8:30 a.m.–12:30 p.m. on early-release days. Staff are not available to supervise students outside of school hours.

If your student is not leaving school using their regularly scheduled district transportation, or if your student is sent home due to illness, the student must be picked up within 45 minutes of parent/legal guardian notification.

The individual picking up the student must be listed in the student's emergency contacts unless alternate authorization has been provided.

Laradon may use photographs of your student in the promotion of Laradon to educate the public about its services and programs.

This may include non-commercial materials such as brochures, flyers, newsletters, annual reports, audiovisual presentations, and Laradon's website. Photographs may also be shared with external media organizations to further promote Laradon's community service efforts.

You may opt out at any time of the use of your student's photographs in promotional materials.

Laradon endorses, supports, and participates in electronic Health Information Exchange (HIE) to improve the quality of your student's health care.

HIE allows secure and efficient sharing of clinical information with other participating physicians and providers, including emergency personnel.

Participation may also help reduce costs by eliminating duplicate tests and procedures.

You may opt out of participation in the CORHIO Health Information Exchange at any time.

Students and their legal custodian have the right to present grievances to Laradon personnel without fear of reprisal. A grievance must be submitted within 30 days of the incident.

1. For a serious problem, the student/legal custodian may first speak with classroom staff, including the teacher.
2. If that conference is not successful, the complaint may be presented to the Treatment Coordinator.
3. If still unresolved, the student/legal custodian has the right to see the Director of Children's Services, who will investigate the incident, complaint, or problem.
4. If still unresolved, the student may go to the Chief Executive Officer (CEO), who will review the issue within three days. The conclusion will be shared with the student/legal custodian within five working days.

Complaints may also be sent to the Colorado Department of Human Services (CDHS), Division of Child Care, Office of Licensing.

The Assistant Director of The Laradon School or the Quality Assurance Specialist can also assist with a complaint or grievance.

You're almost finished!

Please review each statement below and check the box to acknowledge your receipt, review, permission, or authorization as applicable. All required acknowledgements must be completed before submitting the packet.