Authorization to Release Confidential Information Email * Authorization is hereby granted to Irvine Hebrew Day School to obtain/release information about my child. * Student’s Full Name: School Name * School Address * School Phone Number * (###) ### #### Transcripts / Report Cards / Evaluation Reports / School Observations * Yes No N/A Individualized Education Program (IEP) * Yes No N/A Psychological Reports * Yes No N/A Health and Medical Records/Information * Yes No N/A Permanent Record (name, address, birthdate, grade level completed, grades, class standing, attendance) * Yes No N/A Verbal Communication * Yes No N/A By clicking below and submitting this form I agree to the release above. * Yes Your Name * First Name Last Name Thank you for submitting our authorization form. Your information has been saved and submitted.
