I give my permission for St. Vincent de Paul School to secure information regarding:

Student Name:

Date Of Birth:

Verbal Exchange of Information
Regular Division Student Information
Academic Records
Health & Medical Records
Psychological Reports
Social Developmental Reports
Speech & Language Reports
Occupational Therapy Reports
Other

 

I understand that I have the right to review and possibly challenge such records before they are released, and :

I hereby waive that right.
OR
I hereby request an appointment to review and/or challenge the records.

Parent Name:
Parent Address: