2023-2024 Athens City Schools Opt-In for Mental Health Services 
According to Alabama Act. #2022-44, no student under the age of fourteen may participate in ongoing mental health services unless (1) the student’s parent or legal guardian has submitted a written opt-in granting permission for the student to participate or (2) there is an imminent threat to the health of the student or others.  Mental health services include services, treatment, surveys, or assessments relating to mental health, and are provided by social workers or mental health therapists. These include:
  • School-Based Mental Health - On-going counseling services by mental health professionals or private practitioners in the school setting. This may include individual and/or family counseling.
  • Assessments or Surveys - includes questionnaires provided to students related to mental health.
  • Crisis Intervention - Short-term, immediate assistance by mental health professionals.
  • Youth Peer Support Specialist - Provides structured, scheduled activities that promote socialization, recovery, self-advocacy, development of natural supports, and maintenance of community living skills.
  • Therapeutic Mentors - Support and prepare the student in age-appropriate behaviors by restoring daily living, social, and communication skills that have been adversely impacted by a behavioral health condition.
"Mental health services" does not include instructional activities designed to educate students regarding topics related to mental health (1) contained in the school system's approved curriculum or (2) otherwise required to be taught by law (e.g., Erin's Law, Jamari Terrell Williams Student Bullying Prevention Act, etc.).

Information for Parents/Legal Guardians 
If a student’s parent or legal guardian elects to opt-in to services, the professional providing services shall keep the parent informed. The student’s parent or legal guardian shall have the final authority to make decisions regarding any such recommendation a school professional may make for a student to receive counseling or treatment beyond that of which the parent or legal guardian has already opted in. 
 
Review of Materials 
You may request to review any materials used in the guidance and counseling programs available to students by contacting the school principal. 
 
Information Regarding How to Allow, Limit, or Prevent Your Child’s Participation in Services 
If you would like the school system to be able to offer and/or provide services to your child, ages 14 or younger, you must opt-in for each individual service listed for them to participate in that service. A parent or guardian may rescind permission for a student to participate in services at any time by providing written notice to their child’s school principal or mental health specialist. 
 
Recordkeeping 
Written records maintained by the school system and directly related to a student's mental health services will be treated in the same manner as health care records and are subject to the confidentiality protections applicable to education record generally. These records will be kept separately from academic records unless including such record(s) in the student's academic record is necessary to implement a state and/or federal law (e.g., special education referral process).
 
Parents of students with disabilities: Please note that the opt-in process is not applicable to any school counseling services or “mental health services” contained in a student’s IEP or Section 504 plan. Consent for those services will be obtained and information regarding your child’s mental health services will be provided through the usual special education process.
 
Complete the annual School Counseling and Mental Health Services Opt-In Form. 
Sign in to Google to save your progress. Learn more
Student Last Name
Student First Name
Grade Level:
Teacher:
Next
Clear form
Never submit passwords through Google Forms.
This form was created inside of Athens City Schools. Report Abuse