PATH Love Notes Consent Form

This consent form is provided to notify you that your child’s school is partnering with PATH, Inc to provide risk prevention and healthy relationship education through the School Based Love Notes Program. The purpose of this form is to help you decide if you want to allow your high school student son or daughter to (1) participate in the Love Notes Curricula Program and (2) to participate in the program surveys.

What is the Love Notes Program?  
The Love Notes Curricular Program consists of 13 sessions. Love Notes builds skills and knowledge for healthy and successful relationships with partners, family, friends, and co-workers. It is designed to help young people (16-24 years of age) make wise relationship and sexual choices. Wise choices will assist them in achieving their education, employment, relationship, and family goals, while poor relationship and sexual choices may create barriers to these goals.

What is the purpose of the surveys?
Surveys provide data about how the program works and program outcomes. These outcomes are used for the purpose of program improvement. Surveys are confidential and responses are not seen by the school or facilitating programs.

Who runs the program and gives the surveys?
PATH, Inc. in Indiana facilitates the Love Notes Program at your teen's school. ITMESA is the independent evaluator and administers and analyzes all student survey responses. 

Who is participating in the evaluation? 
Students participate as 10th graders (typically but sometimes other grades) during their regular school day.  All students participate in the pre and post survey. In total, approximately 1000 students will participate this year. Some schools will have students participating in the program via the e learning platforms (Google Classroom, Zoom or other). 

What will my teen be asked to do?
Upon your approval, students will participate in the Love Notes program typically on a weekly basis for the 13 sessions.  Some schools may opt to have program 2-3 times per week until completed. They will also complete a pre and post survey as described above.  

What is the survey about?
Survey includes questions about your teen’s knowledge and attitudes regarding such subjects as relationships, sex, drugs, alcohol, and peer violence; and about personal goals and ambitions. A copy of the survey and a full program outline are available to view at in the school office.    

What happens to the surveys?  
Student survey responses are combined with other students and schools by ITMESA.  No individual student responses are shared or available for viewing by the school or program providers. No one in the school will be able to identify your teen.  ITMESA destroys the survey data within a year, after the data are analyzed. Reports provided to program providers are of combined student data and do not identify any individual students or student outcomes.

Is participation required?  
Participation in the program and participation in the surveys is completely voluntary.