Release of Information
District Guidelines for Third Party Information
As parents/guardians, you may need to ask teachers or other school staff to complete behavior ratings, narratives, or provide other school information to physicians, outside counselors, and other agencies. We ask for your cooperation in observing the following guidelines so that forms can be completed accurately to assist in your childs evaluation.
1. All such requests are to be handled through Mrs. Gossett, the school counselor. All forms should be given directly to Mrs. Gossett.
2. The district's written release of information form must accompany the request. Included should be the student name, parent signature, phone number, date, and the name, address, and phone number of the physician or agency requesting the information. You will find a copy of this release form at the bottom of this page.
3. Forms will be mailed or faxed directly to the physician or agency. Please allow at least two weeks from the time the counselor receives the form(s) to the date the physician or agency needs the material.
4. Please identify specifically which teachers are to complete the forms.
5. The school should be provided with enough copies for each teacher who is requested to respond. We cannot reproduce materials. Please be sure the top of each form is completed with your child's name and any other information needed.
As parents/guardians, you may need to ask teachers or other school staff to complete behavior ratings, narratives, or provide other school information to physicians, outside counselors, and other agencies. We ask for your cooperation in observing the following guidelines so that forms can be completed accurately to assist in your childs evaluation.
1. All such requests are to be handled through Mrs. Gossett, the school counselor. All forms should be given directly to Mrs. Gossett.
2. The district's written release of information form must accompany the request. Included should be the student name, parent signature, phone number, date, and the name, address, and phone number of the physician or agency requesting the information. You will find a copy of this release form at the bottom of this page.
3. Forms will be mailed or faxed directly to the physician or agency. Please allow at least two weeks from the time the counselor receives the form(s) to the date the physician or agency needs the material.
4. Please identify specifically which teachers are to complete the forms.
5. The school should be provided with enough copies for each teacher who is requested to respond. We cannot reproduce materials. Please be sure the top of each form is completed with your child's name and any other information needed.