Sample Data Consent Form Template

This data consent form template, an example from the District of Columbia's State Education Agency, establishes consent to share child-level data from local education agencies (LEAs) to the state education agency. In the District of Columbia, if child-level data is shared from the D.C. Office of the State Superintendent of Education (OSSE)—the state education agency—to LEAs or any other entity, a formal data sharing agreement is needed in lieu of a data consent form. This resource includes directions for each section, with opportunities to replace with examples that align to your own agency.

This tool is part of The Early Learning Journey, a collaboration between the Strategic Data Project and representatives from Boston Public Schools, the California Department of Education, Chicago Public Schools, the D.C. Office of the State Superintendent of Education, and the Washington State Education Research and Data Center. It is supported by the Gates Foundation.