The communication below provides important information from the Public Schools of Brookline.

Translations and accessibility options are available at the top of the page.

Arabic (العربية): الترجمة وخيارات الوصول في أعلى الصفحة.
Simplified Chinese (简体中文): 翻译和无障碍选项在页面顶部。
Traditional Chinese (繁體中文): 翻譯和無障礙選項在頁面頂部。
Haitian Creole (Kreyòl Ayisyen): Tradiksyon ak opsyon aksè nan tèt paj la.
Hebrew (עברית): תרגום ואפשרויות נגישות בראש העמוד.
Japanese (日本語): 翻訳とアクセシビリティのオプションはページ上部にあります。
Korean (한국어): 번역 및 접근성 옵션은 페이지 상단에 있습니다.
Portuguese (Português): Tradução e opções de acessibilidade no topo da página.
Russian (Русский): Перевод и параметры доступности вверху страницы.
Spanish (Español): Traducción y opciones de accesibilidad en la parte superior de la página.
Vietnamese (Tiếng Việt): Dịch và tùy chọn trợ năng ở đầu trang.

This page provides translations and more information regarding the Public Schools of Brookline Student Contact Verification Form. The survey questions will first be presented in English (through a screenshot) and then again in the translation of your choice.

Unique responses within the form will be identified within the brackets, e.g. [Your Name Here].

Clicking on any image in this newsletter to enlarge on screen.

All questions within this form will be marked as BOLD and UNDERLINED, with accepted answers listed in parenthesis () and separated with the forward-slash symbol (e.g. Yes / No).

Please note that this page is a resource to help complete the form.

You must still login to the Aspen Parent Portal to complete the actual form. Families who do not have a working digital device at home should contact their school admin team for help in completing this form.

Visit https://www.psbma.org/students-families/parent-portal
Click on the Blue Icon.
You will be taken to the homepage of the Parent Portal.
Login using the email address (Login ID) and password you associate with PSB.

Both Login ID and Password are case sensitive. If you need to reset your credentials, please contact datateam@psbma.org

At the end of every summer, PSB asks families to verify their contact and consent information for their enrolled PK-12 student(s). Accurate contact information helps us communicate with you about school information, progress reports, and when necessary, in emergency situations. We also want to ensure that we are taking good care of your student(s) personal information and only sharing it in ways that you approve.

The Student Contact Verification Form allows parents and caregivers to do a variety of "opening of the new school year" activities. You can update emergency contacts, submit yearly paperwork, update phone numbers, submit home address, and various other changes to the students' and families' information.

Please follow the steps below in order to access the form:

Log into the Aspen Parent Portal.
Click on the widget titled Student Contact Verification to begin the process.
A pop up box will appear listing out all of your students. Select the button next to the student for whom you would like to verify data. Click OK.

If you have multiple children in the PSB and not all of them appear in this list, please let us know right away at datateam@psbma.org. We will amend your account accordingly.
If you do not want to verify the information for the student whose name is showing, click on the magnifying glass again and select a different student in the list that appears

You have now begun the Student Contact Verification Process. Please review each section carefully and verify and/or update the information for the student you’ve selected. You can always Cancel or Save & Close as you are completing the form.

Instructions

PSB asks families to verify their contact and consent information for their enrolled PK-12 student(s). Accurate information in our Aspen Parent Portal helps school staff keep your student(s) safe. Your student’s profile allows us to communicate school information, progress reports, and, when necessary, emergencies to you promptly and efficiently.

If you have been requested to complete this form as part of the plans to prepare for your student’s transition to high school in September 2025, please complete this form to ensure that the Public Schools of Brookline (PSB) have the most up-to-date information in our systems and database.

• If you intend to enroll your student at Brookline High School in September 2025, please click “Next” and complete this form.

• If your student will not enroll at Brookline High School in September 2025, please exit the form by clicking “Cancel” and submit a student withdrawal form. (The withdrawal form is available in the "Tasks" section, just below this form in Aspen. Visit https://www.psbma.org/students-families/registration/withdrawing-your-student for more information)

Student Name: [Your student's name will be listed here]

Address: [Your student's Address Line 1 will be listed here]

City, State, Zip: [Your student's Address City, State and Zip Code will be listed here]:

Proof of Residency Provided: [The most recent school year that PSB has updated residency documentation on file for you student will be listed here]

Lease Expiration Date: [The date of expiration of the most recent lease document on file with PSB, as applicable, will be listed here]

STUDENT Preferred Name: [Your student's preferred name will be listed here]

STUDENT SMS phone (optional to receive text message): [Your student's mobile phone number will be listed here if you opt-in for the student to receive text messages]

Is this student a military dependent? [Answer Choices: No/Not enrolled as Member of a Military family; YesActiveDuty/Yes, child of active duty member; YesDiedActiveDuty/Yes, child of member who died on active duty; YesVeteran/ Yes, child of members or veterans who are medically discharged or retired for 1 year]

Please review your student’s contact information above

• If the “Proof of Residency Provided” value indicates that you have not submitted residency documentation since the 2023-2024 School year or earlier (i.e. 2023-24 school year (“Yes 23-24”) or only partially submitted documentation (“Incomplete”) you must upload one proof of residency and one proof of occupancy in the “Documents” tab when you submit the form. A list of acceptable documents can be found on the “Documents” tab. If you have trouble uploading the documents, please contact enroll@psbma.org.

• If there are any changes to your student’s primary phone number or email, you can edit this information on the “Contacts” tab.

• If there are any changes to your or your student’s address, please exit the form by clicking “Cancel” and submit a student address change form in Aspen. Visit https://www.psbma.org/students-families/registration/change-of-address-and-address-verification for more information)

Residency

You must be a full-time resident of Brookline in order to attend the Public Schools of Brookline. "Residence" is the primary place where a person dwells permanently, not temporarily, and is the place that is the center of his or her domestic, social and civil life. Temporary residence in the Town of Brookline for the sole purpose of attending the Public Schools of Brookline will not be considered residency.

Affidavit of Residency

I certify that I am the parent or legal guardian of the student.
I certify that I reside at the residence shown in this form.
I certify that the student resides with me at the address shown in this form.
I understand that this affidavit will be relied upon by the Public Schools of Brookline for the purpose of determining the above student's eligibility to attend the Public Schools of Brookline on the basis of residency.
I understand that if this student is enrolled in the Public Schools of Brookline based upon the information contained in this affidavit and it is subsequently determined that the student does not actually reside in Brookline:
- The student's enrollment in the Public Schools of Brookline may be promptly terminated AND
- I may be held jointly and severally liable to the Public Schools of Brookline for the student's tuition for the full academic year.
I acknowledge that I am required to notify the Public Schools of Brookline in writing of any change in the student's address within five (5) calendar days of such change and to provide new proof of residency pursuant to the Public Schools of Brookline Admission policy.
I understand that pursuant to Massachusetts law and Public Schools of Brookline policy, students who actually reside in the Town of Brookline may attend Public Schools of Brookline. Students who do not actually reside in the Town of Brookline may not attend Public Schools of Brookline, unless a policy exception applies.

[Response option Descriptions

Yes: I reside in Brookline / I and the student actually reside in Brookline at the residence submitted in this form.
No: METCO Program / Entitled to attend the Public Schools of Brookline through the Brookline METCO Program
No: Materials Fee / Entitled to attend the Public Schools of Brookline through "Materials Fee" tuition waiver program
No: McKinney-Vento / Entitled to attend the Public Schools of Brookline under the McKinney-Vento Homeless Assistance Act
No: Foster Care / Entitled to attend the Public Schools of Brookline as a student in Foster Care
No: Special Education / Entitled to register for Special Education evaluation as a student currently enrolled in Private/Independent school located in the Town of Brookline]

I have reviewed the Public Schools of Brookline residency requirements and affirm that I meet all requirements to enroll my child/ren in the Public Schools of Brookline. (Answer Choices: Yes: I reside in Brookline / No: METCO Program / No: Materials Fee / No: McKinney-Vento / No: Foster Care / No: Special Education)

Parent/Guardian/Other Contact

Click on the listed name(s) to update your contact information.

The Right hand column allows you to request changes to the information listed on record

*The First Table contains the information of the student's CUSTODIAL contacts.

CONTACT UPDATE

Requested Changes

First Name: [First Name of the Contact will be listed here]
Last Name: [Last Name of the Contact will be listed here]
Gender: [The Identified Gender of the Contact is listed here] (Answer choices: F/Female, M/Male, N/Non-Binary)
Relationship: [The Relationship between the Contact and the Student will be listed here] (Answer choices: Aunt, Brother, Court app guardian, Cousin, Dentist, Doctor, Education Surrogate, Father, Foster Parents, Friend, Grandparents, Guardian, Mother, Nanny, Neighbor, Nurse, Other relative, Parent, Relative, Self, Sibling, Sister, Social Worker, Sponsor, Step Father, Step Mother, Step Parents, Uncle, Other)
Contact Lives with student: [The identified residential relationship of the Contact and the Student will be listed here] (Answer choices: Yes, No)
Can pick up: [The permission for the Contact to pick up the student from school will be listed here] (Answer Choices: Yes, No)
Receive email: [The permission for the Contact to receive email regarding the student from school will be listed here] (Answer choices: Yes, No)
Has Physical Custody: [The Physical Custody status (i.e. the student resides with this contact) the Contact has over the Student will be listed here] (Answer choices: Yes, No)
Has Legal Custody: [The Legal Custody status (i.e. the contact maintains legal access to the student's records and information) the Contact has over the Student will be listed here] (Answer choices: Full, Partial, None)

Phone and Email

Primary Phone: [The Primary Phone Number of the Contact is listed here]
SMS Phone (optional to receive text message): [The SMS Phone Number of the Contact is listed here]
Email: [The Primary Email Address of the Contact is listed here]

**The Second Table contains the information of the student's current emergency contacts.

Click on the name to update information about that contact and to identify any contacts that you request to have removed.

Request to delete this contact: [Check box to request the contact be removed from the student's emergency contacts] (Answer choices: blank/keep this contact, checked/request to remove emergency contact)

Select the "Add" button to add a new contact. All Contact information will be updated after the office reviews the forms.

You must click on the "contact removed" box to fully remove a contact from your student contact list.

Please note that you have to check off the box at the top to fully remove the contact from the Student Contact List.

If there are any important changes to the child's health information or concerns, please reach out to the school nurse directly.

* Please provide the following medical information

Primary Physician and Health Insurance

Physician (Answer Choice: Write in the Name of Your Student's Physician Here)
Physician Phone (Answer Choice: Write in the Phone Number of Your Student's Physician Here)
Dentist Name (Answer Choice: Write in the Name of Your Student's Dentist Here)
Dentist Phone (Answer Choice: Write in the Phone Number of Your Student's Dentist Here)
Specialist physician/other provider name (Answer Choice: Write in the Name of Your Student's Specialist Here)
Specialist physician/other provider phone number (Answer Choice: Write in the Phone Number of Your Student's Specialist Here)
Specialist type code (Answer Choice: Allergist / Cardiologist / Immunologist / Occupational Therapist / Orthopedist / Otolaryngologist / Pediatric / Physical Therapist / Psychiatrist / Social Worker / Therapist / Other)
Insurance type (Answer Choice: MassHealth / Medicaid / None / Private / Unsure)
Insurance Name (Answer Choice: Write in the Name of Your Student's Health Insurance Here)
Insurance Number (Answer Choice: Write in the ID Number or Policy Number of Your Student's Health Insurance Here)

Medical Information

Please provide the following medical information:

Allergies (Answer Choices: Yes / No)
Asthma (Answer Choices: Yes / No)
Bleeding Disorder (Answer Choices: Yes / No)
Concussion (Answer Choices: Yes / No)
Convulsions/seizures/fainting spells (Answer Choices: Yes / No)
Diabetes (Answer Choices: Yes / No)
Headaches (Answer Choices: Yes / No)
Hearing Problem (Answer Choices: Yes / No)
Heart Disease (Answer Choices: Yes / No)
Surgeries (Answer Choices: Yes / No)
Varicella/Chicken pox disease (Answer Choices: Yes / No)
Vision problems (Answer Choices: Yes / No)
Other medical, include serious injuries (Answer Choices: Yes / No)

Describe any additional medical conditions for this student. If none, enter "N/A". (Answer Choices: Open Response Field)
What medications does the student take? If none, enter "N/A". (Answer Choices: Open Response Field)
Food Allergen: Click on magnifying glass and select as many options as needed.
Can your student participate in full school activities including physical education, recess and field trips? (Answer Choices: Yes / No)

Parent/Guardian Authorizations

In a medical emergency, I understand and agree that my child will be transported to a hospital. I also understand that every effort will be made to contact me using the contact information provided by me to the school department. I understand that it is my responsibility to update such contact information as needed. If I cannot be reached, I hereby give permission to the physician in charge to hospitalize, secure proper treatment for, and to order injections, anesthesia, and/or surgery for my child. *

(Answer Choices: Yes / No)

Medication Authorization

I give permission for my child to be given these medications, if necessary, at the discretion of the school nurse. My child is not allergic to these medications:

Benadryl/Diphendramine (for the emergency treatment of allergic reactions) (Answer Choices: Yes / No)
Cough drops (if available for minor cough or throat irritation) (Answer Choices: Yes / No)
Hand Sanitizer (Answer Choices: Yes / No)
Hydrocortisone cream (to the skin for itching) (Answer Choices: Yes / No)
Ibuprofen (for fever or discomfort) (Answer Choices: Yes / No)
Tylenol/Acetaminophen (for fever or discomfort) (Answer Choices: Yes / No)

Gif overview of the Consents and Agreements page

Media Release

Do you give consent for photographs, videotaping and interviews of your child to be used in school/classroom projects and publications? (Answer Choices: Yes / No)
Do you give consent for photographs, videotaping and interviews of your child to be used on the PSB web-site and outside media related to school activities. (ie. Newspapers, television, cable)? (Answer Choices: Yes / No)

Family Education Rights and Privacy Act (FERPA)

The Family Educational Right and Privacy Act (FERPA), a Federal law, affords parents and students who are 18 years of age or older certain rights with respect to the student's education records. Please review further information detailed in the FERPA Parent/Guardian Annual Notice found here: FERPA Parent/Guardian Annual Notice.

FERPA allows the Public Schools of Brookline to release certain information about students without parental consent to those who follow appropriate procedures for requesting it. This information, which is generally considered not harmful or an invasion of privacy if released, is knowns as "directory information". The primary purpose of this information is to allow us to celebrate the accomplishments of students by sharing information with the community. Please read the further information about directory information that can be found here before proceeding: FERPA Directory Information Form

The Public Schools of Brookline has identified the following information as directory information.

Student's name, address, parent/guardian name(s), primary email address and telephone number
Participation in officially recognized activities and sports
Height and weight of members of athletic teams
Degrees, honors and awards received
Student's district id number (this cannot be used to access education records and is primarily used as an identifier for such things as library cards)
Dates of attendance/enrollment
Grade level
Most recent school attended

Directory information includes students' contact information, grade level and school, and honors or awards received. The Public Schools of Brookline does not consider photographs or videos of students to be directory information. Examples of District uses of directory information include playbills, the annual yearbook, honor roll or awards lists, graduation programs, PTO directories and athletic team rosters, in addition, the Federal Elementary and Secondary Education Act requires the District to provide all branches of the military with contact information for students unless parent/guardians have advised that they do not want this information disclosed for this purpose.

Do not include in class lists (Answer Choices: A check indicates that you DO NOT want PSB to provide this information)

Do not provide to the school's PTO (Answer Choices: A check indicates that you DO NOT want PSB to provide this information)

Do not use for district program fundraising or other solicitation efforts. (Answer Choices: A check indicates that you DO NOT want PSB to provide this information)

Do not release to US Military recruiters. (Answer Choices: A check indicates that you DO NOT want PSB to provide this information)

Do not release to colleges and other educational institutions (Answer Choices: A check indicates that you DO NOT want PSB to provide this information)

Do not release to scholarship providers. (Answer Choices: A check indicates that you DO NOT want PSB to provide this information)

Do not share information with Town of Brookline Library. (Answer Choices: A check indicates that you DO NOT want PSB to provide this information)

The request to withhold directory information will be in effect from the date it is received by the school or District until the date your student graduates or otherwise leaves the Public Schools of Brookline. You may change your preferences at any time by contacting the district for a new form.

Parent Agreements

lick here to review documents and policies pertaining to Student-Parent Agreement Regarding Student Technology Use, Google Apps for Education Policy, Bullying Prevention and Intervention Plan, and COVID-19 and Health Attestation.

Agree to Bullying Policy (Answer Choices: Yes or No)
Agreement with Google Accounts Policy
Agree to Google Accounts For Education (Answer Choices: A check indicates that you AGREE to this policy.)

PreSchool/PreK-8 Only Section of the Consents and Agreement Page

Walking Field Trip Permission

I give permission for my child to participate in short walks, close to the school, with his/her class during the school year, under the direct supervision of PSB staff. Individual notices for specific field trips will be sent as the need arises. (Answer Choices: A check indicates that you AGREE to this policy.)

Medicaid Consent

Medicaid is a government program in the United States that provides health insurance for adults and children with limited income and resources. Please review further information detailed in the MassHealth Parental Authorization Bulletin and the Medicaid Authorization One-Time Consent Form

I have read the Massachusetts Parental Notice with one-time consent to allow the Public Schools of Brookline to access MassHealth (Medicaid) benefits. This allows our schools to submit claims for school-based health related services to MassHealth. Your consent to allow the district to submit claims through the Municipal Medicaid Program does not alter or reduce you or your child’s MassHealth benefits that students are entitled to receive from MassHealth. (A check indicates that you DO consent)

Early Education Only (BEEP)

Inclusion Agreement

I understand and accept the concept of inclusion and will model an acceptance of all children in the program so that BEEP can create a supportive community. (Answer Choices: A check indicates that you AGREE to this policy.)

To submit a document, click on the "Upload" tab and search for a corresponding file on your computer. Submit sperate file for each of the sections of the tab. Once the file has been uploaded to Aspen, the following fields will be completed:

Name: [Name of the File within Aspen. You can rename this as necessary]
Type: [Type of File - e.g. Custody Document, Immunization Record, etc.]
FileName: [Original Name of the File ]
Document: [Copy of the File that is now uploaded]

HEALTH RECORDS (If applicable)

• Most Recent Immunization Records

• Physical Exam Report (if separate from Immunizations) (4th, 7th, 11th grade ONLY)

• Most Recent Health Records

*The state requires a physical exam completed within the previous 12 months be provided to the school nurse for all students entering the following grades: 1st, 4th, 7th, 10th. Please upload this document here only if applicable. All other health information including care plans and medication orders should be given directly to your school nurse.

PROOF OF RESIDENCY (One (1) Required, if applicable)

Acceptable Proofs Include:

Most recent mortgage payment
Most recent property tax bill
Closing Disclosure (previously known as a Settlement Statement) (for new home purchases within 45 days of registration only)
Quit Claim Deed (for new home purchases within 45 days of registration only)
Active Lease Agreement
Residency Certification Form (for families unable to provide any of the above documents in their own name)

PROOFS OF OCCUPANCY (One (1) required, if applicable)

Utility statements from different companies dated within the last 45 days, accepted proofs include:

Cable/Internet Bill or Statement of Service
Electric Bill or Statement of Service
Oil Bill or Statement of Service
Gas Bill or Statement of Service
Home/Renter's Insurance Policy
PSB Occupancy Appeal Form (For use only by Parents/Guardians/Caregivers/Students unable to provide Proof of Occupancy Documentation as listed above in their own name)

Done!

Done

Enter your name below. It is a legally binding electronic signature that will be added to the District Contact Verification form. *

Please restrict your signature to be less than 25 characters.

Answer choice [Free Text - Enter your name]

To update your address, please submit an Address Change workflow.

When all information is accurate and complete, click Submit.

Frequently Asked Questions (FAQ)

I need to complete my residency verification. Can I do that here?
Only if your address has not changed. Residency verification can be completed through the Student and Medical Verification form. You cannot change your child’s address through the Parent Portal. All address verification and changes must be made through the Registration & Enrollment (ORE) at https://www.psbma.org/students-families/registration/change-of-address-and-address-verification. Please do not email residency verification documents to the Data Team.

What information can I change with this?
You can update your child’s contact information, contact information for all existing parents/guardians and emergency contacts, and consent information. You may also add new emergency contacts.

If you identify an error in your child’s address please contact the Office of Registration and Enrollment at enroll@psbma.org. To change demographic information for your child, please contact the main office at your school.
I don’t know my login ID or password. / I am receiving an error message that my account has been disabled or that I do not have permission to access.
If you have already logged in once in the past, please try the “I Forgot My Password” link on the login page. Please check with the child’s other parent/guardian, if applicable; sometimes one parent/guardian will change the password.

If that doesn’t work, please email us at datateam@psbma.org and we will reset your account for you. Though we will work to fix this as quickly as possible, please allow up to three business days for resolution.

Please note that you will likely receive a red pop up box requiring you to change your password the first time you log in. This is not an error.
My neighbor/friend who is also a PSB parent/guardian did not receive the message about contact verification/consent. / My spouse/partner/the child’s other parent did not receive the message about contact verification/consent.
Please ask them to email us at datateam@psbma.org to ensure that we have an up-to-date email address for them.

If a parent with legal, non-physical custody would like a separate login, please have them request this directly from your child’s school, as there is a notification process that must be followed.
I can’t see all of my children when I log in.
Please email us at datateam@psbma.org and let us know which student(s) you can’t access. We will update the student contact record. At that point you can log out and log back in and you should be able to see all of your students. Please allow up to three business days for resolution.
Is this secure?
Yes. We use a well-respected student information system that is approved by the State of Massachusetts for mandatory data reporting. All information is stored on highly secure encrypted servers. All data maintenance and use activities adhere to federal FERPA guidelines. The Public Schools of Brookline takes great care to maintain the privacy and security of our students and families. If you would prefer to complete this verification using a paper form, however, please let us know via email and we will be happy to accommodate the request.
What else can I do with the Parent Portal?
The Parent Portal currently allows you access to your student’s current and past schedule/homeroom, attendance, and grades. You can also access important documents and forms. Report cards and progress reports will be published to the Parent Portal. You can access all final report cards from the 2015-16 school year forward.

Aspen Parent Portal Tutorial