Maryland Youth Tobacco and Risk Behavior Survey Opt-Out Form
This file is the parental opt-out form for the Maryland Youth Tobacco and Risk Behavior Survey. It provides information regarding the survey and instructions for how to opt-out children from participating. Filled forms should be returned to the school within 3 days.
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How do I fill this out?
To opt-out your child from the survey, please follow these steps. Make sure to read the instructions carefully. Ensure the form is completed accurately.
How to fill out the Maryland Youth Tobacco and Risk Behavior Survey Opt-Out Form?
1
Read the form carefully.
2
Check the box indicating you do not want your child to participate.
3
Print your child's name and grade.
4
Sign and date the form.
5
Return the completed form to your child's school within 3 days.
Who needs the Maryland Youth Tobacco and Risk Behavior Survey Opt-Out Form?
1
Parents who do not want their child to participate in the survey.
2
Schools needing to distribute the opt-out forms to parents.
3
Health departments monitoring opt-out rates.
4
School administrators tracking survey participation.
5
Researchers analyzing survey participation data.
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1
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2
Use the editing tools to make necessary changes.
3
Fill in your child’s details, if needed.
4
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5
Save the edited document.
What are the instructions for submitting this form?
To submit this form, ensure that it is fully completed, signed, and dated. Return the form to your child's school within 3 days of receipt. Submission methods may include handing it to the school office, sending it via your child to their teacher, or mailing it to the school's main office. Make sure to keep a copy for your records. If you have any questions, contact the school directly.
What are the important dates for this form in 2024 and 2025?
Forms should be submitted within 3 days of receipt. For the 2024 and 2025 surveys, ensure to return the form by the deadline provided by your child's school to avoid late submission.
What is the purpose of this form?
The purpose of this form is to provide parents with the option to opt-out their child from participating in the Maryland Youth Tobacco and Risk Behavior Survey. The survey is conducted to collect data on health-risk behaviors among students, which helps inform health programs and policies. By completing and returning this form, parents can ensure their child's exclusion from the survey if they choose not to participate.
Tell me about this form and its components and fields line-by-line.
- 1. Opt-Out Checkbox: Check this box if you do not want your child to participate in the survey.
- 2. Child's Name: Print your child's name clearly.
- 3. Child's Grade: Indicate your child's current grade level.
- 4. Parent's Signature: Provide your signature to authorize the opt-out request.
- 5. Date: Enter the date you completed and signed the form.
What happens if I fail to submit this form?
If you fail to submit this form, your child will be included in the survey by default. This can affect your child's participation in the school activity as outlined by the survey.
- Automatic Participation: Without the form, your child will take part in the survey.
- Survey Inclusion: Your child's data will be collected and included in the survey results.
- Missed Opt-Out Window: Failing to submit the form in time means missing the opt-out opportunity.
How do I know when to use this form?
- 1. Parent Decision: When you, as a parent, choose to opt-out your child from the survey.
- 2. Privacy Concerns: If you have concerns about your child's privacy and data collection.
- 3. Sensitive Content: If you find some survey questions sensitive for your child.
- 4. Health and Safety: If you believe the survey might affect your child's well-being.
- 5. Personal Beliefs: If the survey content conflicts with your personal or family beliefs and values.
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