Get The Virginia Project For Children And Young Aduts With Deaf ... - Vcu

Filling out The Virginia Project for Children and Young Adults With Deaf-Blindness Authorization for the Release of Records form is an important process for parents, guardians, or students seeking services. This guide provides clear, step-by-step instructions to assist you in completing the form accurately and efficiently.

Follow the steps to successfully complete the online form.

1. Click the ‘Get Form’ button to obtain the form and open it in the editor.
2. In Section A, fill in the student's full name and date of birth. Choose the gender by marking either 'Male' or 'Female'.
3. Provide the details of the agency or individual from whom records will be released in the designated fields under 'From' and 'To'. Include the name, street address, city, state, and zip code.
4. In Section B, mark the types of records you provide permission to disclose, including vision, educational records (IEP and assessment summaries), hearing, medical, and any other categories as needed.
5. State the reason for disclosing the records, specifying the need to determine eligibility for services related to dual sensory impairment or deaf-blindness.
6. Indicate the validity period for the authorization by filling in the dates at the end of Section B. Note that for medical records, this can be no longer than 90 days.
7. In Section C, write the name and address of the parent or guardian. Provide a phone number and email address for communication.
8. Ensure you add your signature and date at the bottom of the form, confirming your relationship to the child.
9. Once all sections are complete, review the form for accuracy. You can then save changes, download, print, or share the completed form online.

Begin filing your documents online today to stay compliant and organized.