Practice Pulse - Parental Consent Form

The form ensures compliance with COPPA and FERPA regulations for your child's use of our application.

* Indicates required question

Child's Full Name*

Child's Email Address (For App Access)*

Child's Date of Birth

Parent/Legal Guardian's Full Name*

Parent/Legal Guardian's Email Address

Parent/Legal Guardian's Phone Number

I understand and consent to my child using the Practice Pulse mobile application

Yes, I consent.

I have read and agree to the Practice Pulse Privacy Policy, which outlines how my child's data will be collected, used, and protected in compliance with COPPA and FERPA

Yes, I agree.

I authorize Pulse Ed, Inc. to collect and use my child's information as described in the Privacy Policy for the sole purpose of providing and improving the app's services

Yes, I authorize.

I understand that I can review or request the deletion of my child's data and/or education records at any time by contacting Practice Pulse support (help@practicepulse.com)

Yes, I understand.

How would you rate your understanding of our data privacy practices after reviewing the Privacy Policy?

Poor

Excellent

Please provide any additional comments or questions regarding the consent

Clear form?