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It is your obligation to complete, sign, and present, a separate Student. The following information presents selected sections of the policy that are particularly relevant to student authorization to release a record to a third party.The form must be entirely completed and signed. Failure to do so may result in a delay in processing this request to release your medical record information. This notice explains how we meet this commitment. The Family Education Rights and Privacy Act (FERPA) is a federal law that protects the privacy of student records, both financial and academic. Clark County School District. This form may not be used for the release of protected health information or treatment records. The medical record information release (HIPAA) form allows a patient to give authorization to a 3rd party and access their health records. Indian Health Service.