Sample Release of Information Forms

Guidelines concerning confidentiality should include the following:

1. The institution has the responsibility to maintain appropriate confidentiality of records and communication, except where permitted or required by law. All information about a student with a disability should be confidential. This includes conversations and information shared between:
1. the service provider and faculty
2. faculty and the student
3. the tutor and the student
4. the student and the service provider
5. service providers/staff/faculty and parents

2. The student should sign a release form that specifically states what written information about the student may be exchanged and who is entitled to receive that information.
3. Anyone involved with arranging services for the student should be made aware that all information concerning the student’s disability(ies) is confidential.
   Statement of Confidentiality Form for DSS employees (University of Baltimore) (MS Word .doc)
   
4. Student files are strictly confidential and may not be reviewed by any individual who is not specifically named on a release form.
5. Instructor's questions regarding a student's disability should be directed to the students unless specific written permission to share that information has been given to the service provider. Accommodations letters may include statements signed by the student allowing confidential information to be shared with instructors.
6. Memos to instructors to set up accommodations should state the general category of "a student with a documented disability," rather than give specifics about the student’s disability. Exceptions may include (upon student's permission): seizure disorder, diabetes, allergies, or other conditions where it would be helpful for the instructor to know what may occur or what to do in a particular event.
7. Students who choose to disclose to an instructor should be encouraged to focus only on classroom behaviors, academic difficulties and necessary accommodations.
8. All forms containing the student’s name, social security number and disability-related information should be marked CONFIDENTIAL.

Sample Release of Information Forms