Parental Consent Form

To maintain high-quality care and comply with the Behavior Analyst Certification Board (BACB) regulations, Registered Behavior Technicians (RBTs) must undergo direct clinical oversight.

The Board Certified Behavior Analyst (BCBA) must observe the RBT delivering direct services to your child for at least 5% of their monthly service hours.

Conducting this observation virtually allows the BCBA to evaluate technician skills and guide behavior strategies remotely without physical disruption to your child's session.

All virtual supervision interactions, synchronized video feeds, and data transmissions will take place exclusively via encrypted, secure platforms that possess an executed Business Associate Agreement (BAA) in full compliance with federal Health Insurance Portability and Accountability Act (HIPAA) regulations.

The RBT is strictly required to ensure their immediate remote physical environment is private, uncompromised, and secure against eavesdropping or unauthorized visual access during all video review sequences.

Please review and authorize or deny each specific activity below.

In the event that the RBT exhibits performance or competency deficiencies during virtual reviews, the BCBA will initiate a structured Remedial Action Plan.

Parents are hereby notified that such plans are designed to preserve clinical efficacy, may involve an increased frequency of remote observation blocks, and ensure the child's programming is executed accurately.

If a performance plan is active, the BCBA will maintain ongoing communication with the family regarding program stability.