My child’s behavior plan has been reviewed with me, including information on procedures to prevent and respond to behaviors targeted for decrease as well as teaching and reinforcement strategies for functional replacement behaviors targeted for increase.
I agree to all interventions as described in my child’s behavior analysis service plan. I have had the opportunity to ask questions and receive further clarification on procedures as needed. I also acknowledge that my Behavior Analysis service providers may terminate services if I am not implementing the strategies, I consented to in this behavior plan.
If progress is not being made within 6 months utilizing the procedures listed in this behavior plan, the behavior analyst will make modifications as needed, including updating this behavior plan. If I wish to terminate behavioral services with my current provider at any time, I will notify the behavior analyst and consent to the behavior analysis service plan will be withdrawn immediately
My signature denotes my consent to the implementation of this plan in the specified environments.