BMS Request for Medical Assessments and permission for consultation

BMS Request for Medical Assessments and permission for consultation

  • To Parent:

    As part of our committment to serve the needs of your child, we are asking for your permission to receive any neuropsych or other medical assessments for your child and permission to consult with your child's Medical Doctor, therapist, or other medical specialist that provides services to your child.  

    Because your child’s medical professional cannot provide those records or consultation without your consent, please complete and sign this form and submit it to your child’s medical professional.

  • atttends Bellevue Montessori School. As part my child's enrollment, Bellevue Montessori School is requesting for access to any assessment given to my child and permission to have a consultation with my child's medical professional so that the teachers and staff at Bellevue Montessori School can support my child. 

    Please scan and send these records and any others requested by Bellevue Montessori School to or send hard copies to:

    Learning Specialist

    Bellevue Montessori School

    2411 – 112th Avenue NE

    Bellevue, WA 98004

    Please call Bellevue Montessori School at 425-454-7439 if you have any questions.

    Thank you for your assistance.

    Bellevue Montessori Administrative Team

  • Date Format: MM slash DD slash YYYY