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PARENT/GUARDIAN LETTER OF CONSENT FOR MINORS GSA Youth Advisory Council
Dear Parent/Guardian:
In collaboration with The Arizona Department of Behavioral Health Services and The Community Partnership of Southern AZ, we are facilitating a Youth Advisory Council (Y.A.C.) for youth ages 12 through 21 years. The purpose of this council is to determine needs in your community regarding behavioral health services for adolescents and families.
We are inviting your child's participation in the Youth Advisory Council. Meetings are held monthly, and are 1 ½ to 2 hours long. Your child's participation in this council is completely voluntary. The council provides an opportunity for youth receiving services to have a voice, and to inform themselves and others. Input generated by the Youth Advisory Council will be used to enhance the behavioral health system of care in our region, with the goal of eliminating barriers and improving services to adolescents in Arizona’s behavioral health system.
We value your child’s time and participation in this important effort. For this reason, a $25.00 gift card will be provided to your child each time he or she participates in the council meetings.
If you have any questions concerning the Youth Advisory Council, or your child's participation in this effort, please feel free to call us. Sincerely,
Deanna Bellinger Executive Director NAMI Southeastern AZ
(520) 459-3228, (800) 380-2322 Resource Center: 77 Calle Portal Ste A280, Sierra Vista, AZ 85635
For your child to participate, please complete form and mail to above address
By signing below, you are giving consent for your child
_______________________________________________________ (child's name) to participate in the Youth Advisory Council.
______________________________________________ Signature
______________________________________________ ________________ Printed Name Date
please print this page and mail to:
Questions: (520) 459-3228 OR (800) 380-2322 |