Protection of Pupil Right Amendment (PPRA) Notice and Survey Opt-Out

The Protection of Pupil Rights Amendment (PPRA), 20 U.S.C. § 1232h, requires the School District to notify you and obtain consent or allow you to opt your child out of participating in certain school activities. These activities include a student survey, analysis, or evaluation that concerns one or more of the following eight areas (“protected information surveys”):

  1. Political affiliations or beliefs of the student or student’s parent;
  2. Mental or psychological problems of the student or student’s family;
  3. Sex behavior or attitudes;
  4. Illegal, anti-social, self-incriminating, or demeaning behavior;
  5. Critical appraisals of others with whom respondents have close family relationships;
  6. Legally recognized privileged relationships, such as with lawyers, doctors, or ministers;
  7. Religious practices, affiliations, or beliefs of the student or parents; or
  8. Income, other than as required by law to determine program eligibility.

This requirement also applies to certain physical exams and screenings.

Following is a schedule of activities requiring parental notice and consent or opt-out for the upcoming school year. This list is not exhaustive and, for surveys and activities scheduled after the school year starts, the District will provide parents with prior notification of the surveys and activities and the opportunity to opt their child out, as well as an opportunity to review the surveys. (Please note that the rights described in this notice transfer from parents to any student who is 18 years old or an emancipated minor under Iowa law.)

Opt-out Process: Parents/guardians can opt a student out of the specified activities, described below, by completing this Protection of Pupil Right Amendment (PPRA) Notice and Survey Opt-Out form by September 9, 2022. Please read the following activity details and complete the questions at the bottom of the form. 

Activity: The Greater Sioux City Metro Area Survey on Alcohol and Drugs

Dates: September 10, 2022 - October 31, 2022 

Grades: 6, 8, and 11

Summary: The survey has been conducted by Siouxland CARES for 20 years in Siouxland. Data is gathered from the Sioux City Community School District, Dakota Valley, South Sioux City Schools, Lawton Bronson, Sgt. Bluff, Correctionville, Bishop Heelan, Moville, and Elk Point. The survey is administered by school officials and contains questions related to self-reported substance use, exposure to substance use by friends, perceived ease/difficulty in obtaining alcohol, tobacco, and other drugs, as well as the perception of harm. The data is collected by Siouxland CARES and the scores from all schools are combined and reported in aggregate to community agencies in Siouxland. These agencies use the data to plan programming and resources to fulfill community needs related to the survey findings.

Activity: Iowa Youth Survey

Dates: Spring (Administered every two years. Will not be administered during the 2022-2023 school year.) 

Grades: 6, 8, and 11

Summary: The Iowa Department of Public Health (IDPH) directs the Iowa Youth Survey. The purpose of the survey is to collect information from Iowa youth so we can better understand their beliefs, values, and decisions about what makes them feel secure, strong, and safe in their communities, schools, and families. In addition, information is collected about their experiences with and ideas about alcohol, tobacco, drugs, bullying and harassment, and violence prevention. The information collected helps state planning agencies, schools, and local community task forces put together valuable future programming. It is important to ask children to tell us what is good and working about their lives in Iowa and what needs improvement.

Some areas on the questionnaire will have sensitive questions about tobacco, alcohol, illegal drugs, and thoughts on violence and safety. It is important to remember that our school children do not live in identical environments. All children and families do not have the same beliefs, attitudes, or values. Your child/children may make very different life choices than other children. If we are going to plan programming that keeps all children safe and connected to their families, schools, and communities, we need to know what all Iowa children are thinking, saying, and doing.

The behavioral health portion of the survey asks questions about mental health, bullying, and adult student relationships. The information collected will help the district educate youth about mental health issues, including available resources. The survey asks questions about mental health, bullying, and adult student relationships. The information collected will help the district educate youth about mental health issues, including available resources.

Activity: Social and Emotional Health Screening

Dates: Twice during the 2022-23 school year: once the first semester (between September 26, 2022 – November 18, 2022) and once the second semester (between February 27, 2022 – April 28, 2023).

Grades: TK - 12

Summary: This is a survey that asks students questions about their social and emotional health, family, and school safety.  

I, the parent/guardian, am electing to opt my child/children out of the following activities during the 2022-2023 school year: *
Names of child/children who will not participate in the activities selected above:
My signature below states: I do not want my child/children, listed on this form, to participate in the activities indicated in the checkbox. I understand that a neutral activity will be provided for them during the activity time(s) and that there is no penalty for not participating. I understand that this refusal of consent needs to be received by the District no later than September 9, 2022. 
Parent Signature *

Right to Review Survey Materials:

If you wish to review any survey instrument or instructional material used in connection with any protected information or survey, please submit a request to your school administrator.  You will be notified of the time and place where you may review these materials. You have the right to review a survey and/or instructional materials before the survey is administered to a student.


The Sioux City Community School District offers career and technical programs in the following areas: Business & Marketing, Family & Consumer Science, Health Science, and Industrial Arts, Technology, & PLTW. 

The Sioux City Community School District is an equal opportunity/affirmative action employer and does not discriminate on the basis of race, creed, color, sex, sexual orientation, gender identity, genetic information (for employment), national origin, religion, age (for employment), disability, socioeconomic status (for programs), marital status (for programs), or veteran status (for employment) in its educational programs and its employment practices.  The District is required by Title IX and 34 CFR Part 106 not to discriminate on the basis of sex in its programs, activities, or employment.   

Inquiries or grievances under Section 504  and Title II of the Americans with Disabilities Act may be directed to Dr. Dora Jung, Director of Student Services & Equity Education/Title IX Coordinator at 627 4th Street, Sioux City, IA 51101, (712) 279-6075, Inquiries about the application of Title IX and its regulations to the District may be referred to the Title IX Coordinator, the Assistant Secretary of the U.S. Department of Education, or both. Please see District Board policies 103 and 504.4 for additional information on available grievance procedures.