Who We Are
UCLA Wellness Program
Consent for UCLA Wellness Program
PERMISSION FOR UCLA's 9TH GRADE WELLNESS PROGRAM
Dear Parents and Legal Guardians:
The transition to high school can be stressful for many students. Alhambra Unified School District's Gateway to Success program is launching the UCLA Student Wellness program for incoming 9th graders to build stress management skills.
When adolescents are stressed, many cope in unhelpful ways. Learning to Breathe (L2B) is a mindfulness-based program that teaches adolescents healthy ways to cope with stress, increase awareness, and take care of themselves
will learn to pay attention to their thoughts and feelings, and better manage their emotional response. The program has been found to reduce stress, improve attention, and increase school performance for adolescents.
This enrichment program is
free of charge
and open to academically motivated students who are experiencing some stress or looking to improve attention and concentration. To be selected, your child must first complete a questionnaire about stress, mood, and school achievement goals. If your child is selected, they will attend a 12-week wellness program at their school. Arrangements will be made for your child to participate during school.
Participation is voluntary. If you would like your child to be considered for the UCLA
Wellness program, please check the box below and provide your child’s information to provide permission. If you have any questions about the program, please feel free to call Gateway To Success at (626) 943-3410.
Laurel Bear, Ph.D., Assistant Superintendent Student/Employee Welfare
Anna Lau, Ph.D., University of California, Los Angeles
Joey Fung, Ph.D., Fuller School of Psychology
I have read and understand the above information regarding the UCLA Wellness Program for 9th grade students.
I GIVE PERMISSION for my child to complete the questionnaire and to participate in the wellness program if my child qualifies. I also consent to Gateway To Success to provide support services such as mental health services, psycho-education, referrals to counseling services, and to AUSD to share information from my child's education record, including contact information, attendance records, discipline record, class schedule, transcript, health and special education records, and testing results, with Gateway To Success and its staff for the purposes of this program.
Alhambra Unified School District
1515 West Mission Road, Alhambra, CA 91803
Phone: (626) 943-3410
Fax: (626) 943-8036