NOTICE OF INTENT TO COLLECT PRIVATE INFORMATION  

The Follow Along Program is a no cost, voluntary program from the Minnesota Department of Health (MDH) and your local public health (LPH) agency. The Follow Along Program helps families support their child’s learning and growing. To participate, MDH and LPH will collect information (data) you provide about your child in a questionnaire. You will receive the questionnaire results. A public health provider will contact you if there are any concerns and connect you with people or programs to help. The information you provide is also used to evaluate the program. The Minnesota Government Data Practices Act classifies the information you provide as private. The information you provide may be seen by employees of MDH, your LPH agency, Brookes Publishing Company, other contractors, and others when required by law. You do not have to give information, but if you don’t, you may not be able to fully participate. You may withdraw your permission at any time by telling MDH of your intent to withdrawal in writing. Information already shared cannot be taken back. If you have a question about this notice, please email [email protected] or call 1-800-728-5420.  

By submitting my information, I acknowledge receiving the above Privacy Notice ("Tennessen Warning") and give permission to MDH to collect and use my child’s information as described above.