Hamden Public Schools

July 29, 2019

5125 - Student Records; Confidentiality (Regulation)

REGULATIONS REGARDING CLASSIFICATION OF EDUCATION RECORDS

The Superintendent as Chief Custodian of Records is charged with district-wide responsibility for implementing BOE policies and regulations. The Superintendent will appoint a Custodian of Records for each category of records who will ensure that student education records are kept as follows:

A. CATEGORY “A” RECORDS:

1. Category A includes official administrative records that constitute the minimum personal data necessary for the operation of the educational system.

2. Category A records shall be maintained for at least fifty (50) years after the student leaves the school district or graduates.

3. Notice of a student’s suspension or expulsion shall be expunged from the student’s cumulative education record if the student graduates from high school, except for notice of an expulsion for possession of a firearm or deadly weapon by students in grades 9-12.

4. *In cases where a student is suspended or expelled, and the Administration or the Board, respectively, has shortened or waived the period of suspension or expulsion in accordance with the Board’s disciplinary policy, the Administration or the Board, respectively, may choose to expunge such notice of suspension or expulsion from the student’s cumulative record at the time the student completes the specified program and any other conditions imposed by the Administration/Board, rather than upon graduation. Should the notice be expunged in accordance with this provision, a record of the fact that the student had been suspended or expelled shall be maintained apart from the student’s cumulative record, for the limited purpose of determining whether any subsequent offenses by the student would constitute the student’s first suspension or expulsion.

5. Category A records shall include, at a minimum, the following:

RECORD	LOCATION
a. Basic biographical information	Cumulative/Health File
b. Academic achievement (grades/transcripts)	Cumulative File
c. Date of high school graduation or equivalent	Cumulative File
d. Records of immunizations	Cumulative/Health/Pupil Personnel File
e. Attendance records (days absent/present/tardy)	Cumulative File
f. *Notice of Expulsion for Firearm or Deadly Weapon (C.G.S. 10-233c(e) , 10-233d(f) )	Cumulative File

B. CATEGORY “B” RECORDS

1. This includes verified information for the formulation of education programs for all students, but not absolutely necessary over an indefinite period of time.

2. Data in Category B must be accurate, clearly understood, and verified before becoming part of any continuing record. There should be no anonymous entries in a student's education record.

3. Category B records must be maintained for at least six (6) years after the student leaves the school district or graduates from high school.

4. Notice of a student’s suspension or expulsion shall be expunged from the student’s cumulative education record if the student graduates from high school, except for notice of an expulsion for possession of a firearm or deadly weapon by students in grades 9-12.

5. *In cases where a student is suspended or expelled for the first time, and the Administration or the Board, respectively, has shortened or waived the period of suspension or expulsion in accordance with the Board’s disciplinary policy relating to first time offenses, the Administration or the Board, respectively, may choose to expunge such notice of suspension or expulsion from the student’s cumulative record at the time the student completes the specified program and any other conditions imposed by the Administration/Board, rather than upon graduation. Should the notice be expunged in accordance with this provision, a record of the fact that the student had been suspended or expelled shall be maintained apart from the student’s cumulative record, for the limited purpose of determining whether any subsequent offenses by the student would constitute the student’s first suspension or expulsion.

6. Records containing information pertaining to child abuse/neglect referrals or reports; or containing confidential HIV-related information should be kept separate from the student’s cumulative folder, in confidential files.

7. Confidential HIV-related information contained in the confidential file should only be disclosed pursuant to district policy.

8. Information contained in documents related to any Department of Children and Families (“DCF”) child abuse and/or neglect investigation, or any such investigation conducted by local law enforcement officials, shall be kept confidential. Such records shall only be disclosed in accordance with the Board’s policy regarding Confidentiality and Access to Education Records.

9. Category B records shall include the following (if applicable):

RECORD	LOCATION
a. Child-Study Team Records / Student Assistance Team Records	Cumulative/Pupil Personnel File
b. Standardized group test scores (CAPT, CMT etc.) and/or personality testing program results	Cumulative/Pupil Personnel File
c. Diagnostic reading/math test results (not special education)	Cumulative File
d. Educational and/or vocational interest	Cumulative File
e. Speech/language and hearing evaluations (not special education)	Cumulative/Health File
f. Comprehensive health records	Cumulative/Health/Pupil Personnel File
g. Correspondence relating to the student	Cumulative/Health/Pupil Personnel File
h. Suspensions/expulsions	Cumulative File*
i. Parent/eligible student’s signed release forms	Cumulative/Health/Pupil Personnel File
j. Truancy Records (including record of parent conferences and referrals )	Cumulative File
k. Child Abuse/Neglect Forms	CONFIDENTIAL FILE/Principal
l. Reports Containing Confidential HIV-Related Information	Health File
m. Awards	Cumulative File
n. Diagnostic test results (non special education)	Cumulative File/Pupil Personnel
o. Extracurricular Activities	Cumulative File
p. Letters of Recommendation	Cumulative File
q. Parent’s/Eligible Student’s signed release forms (permitting disclosure of records)	Cumulative File/Health/Pupil Personnel File
r. Diploma (if not picked up by student)	Cumulative File
s. Accident Reports	Cumulative File
t. Basic school entrance health histories	Cumulative/Health File
u. Cumulative Health Record (CHR-1, original or copy)	Health File (*copy remains with district/original follows student)
v. Individualized Health Care Plans / Emergency Care Plans	Cumulative/Health/Pupil Personnel File
w. Health Assessment Records (HAR-3)	Health File
x. Incident Reports	Cumulative File
y. Medication administration records(*6 yrs OR until superseded by yearly summary on CHR-1)	Health File
z. Parent authorization for medications/treatments	Health File
aa. Physician’s orders for medications treatments	Health File
bb. Referral forms for services based on results of mandated screenings	Health/Pupil Personnel File
cc. Sports histories and physical-examination reports	Health File
dd. Nursing Records (Health assessment data; Nursing process notes; 3^rd party health records)	Health File
ee. Section 504 Records	Health File

C. CATEGORY “C” RECORDS – SPECIAL EDUCATION

1. Category C includes verified information necessary for the formulation of prescriptive educational plans designed to meet the unique needs of selected students.

2. Category C information should be kept separate from the student's cumulative folder, in the Pupil Personnel File.

3. Category C records must be maintained for at least six (6) years after the student leaves the school district or graduates from high school.

4. Prior to the destruction of Category C information, notification to parents and/or eligible students via media will be made and opportunity provided to copy said records.

Category C shall include (where applicable):

RECORD	LOCATIONS
a. PPT referral forms	Pupil Personnel File
b. School counselor case records	Cumulative/Pupil Personnel File
c. School psychologists case records	Cumulative/Pupil Personnel File
d. School social-work case records	Cumulative/Pupil Personnel File
e. School speech/language pathology case records	Cumulative/Pupil Personnel File
g. Special Education assessment/evaluation reports	Pupil Personnel File
h. Due process records (including complaints, mediations, and hearings)	Pupil Personnel File
i. Individual Transition Plan	Pupil Personnel File
j. Individualized Education Program (“IEP”) Records	Pupil Personnel File
k. Planning and Placement Team (“PPT”) records (including notices, meetings, consent forms)	Pupil Personnel File
l. Individualized Family Service Plans (“IFSPs”)	Pupil Personnel File

D. CATEGORY “D” RECORDS

1. Category D records must be maintained for minimum retention period specified below.

Category “D” shall include (if applicable):

RECORD	MINIMUM RETENTION REQUIRED	LOCATION
a. Sports Contract/Student Contract (including signature sheet for student handbook)	End of school year in which signed	Cumulative File
b. Permission slips / waivers	3 years	Cumulative File
c. Free/reduced meal application and documentation	3 years	Cumulative File
d. Annual Notification to Parents (Student behavior and Discipline, Bus Conduct, Electronic Communications Systems, and the National School Lunch Program)	1 year	Cumulative File
e. Adult education Registration Records	3 years or until audited, whichever comes first	Cumulative File
f. After school program registration records	1 year	Cumulative File
g. Pesticide application notification registration form	5 years	Cumulative File
h. School registration records including residency documentation	3 years or until audited, whichever comes later	Cumulative File
i. Student portfolio work (student produced work for grading assessment)	End of year in which student received grade	May be Maintained by Individual Teachers
j. Tardy slips from parents/guardians	End of school year	Cumulative File
k. Physician’s Standing orders	Permanent; revise as required. Keep old copy separately.	Health File
l. Student’s emergency information card	Until superseded or student leaves school district	Cumulative/Health File
m. Test Protocols	Discretion of district	Cumulative/Pupil Personnel File
n. Surveillance videotapes made on school bus (*if maintained by district)	2 weeks	N/A
o. Log of access to education records	Maintained for same retention period as required for the record	Cumulative/Health/Pupil Personnel

E. DURATION OF EDUCATION RECORDS

1. Records shall be destroyed in accordance with district policy and the Records Retention Schedule of the Public Records Administrator.

2. Records may be maintained for longer periods of time whenever valid cause for the retention of records is shown to the custodian of records.

3. Notwithstanding the applicable retention schedule, the school district shall not destroy any education record if a parent or eligible student has an outstanding request to inspect and review the education record.

F. RESPONSIBILITY FOR MAINTENANCE OF EDUCATION RECORDS

1. The Superintendent is the Chief Custodian of Records.

2. In addition, the following personnel are designated as the guardians of records for each of the schools:

a. Categories A, B & D: Building Principals

b. Category C: Director of Special Education

c. With respect to confidential HIV-related information, the Nurse shall be the guardian of records. With respect to child abuse and neglect investigation material, the Principal at each school shall be the guardian of the records.

3. The Superintendent will annually list for public inspection the names and positions of the custodians of records in each of the schools.

4. Each of the custodians of records shall supply parents, on request, a list of the types and locations of education records collected, maintained, or used within the school district.

5. The custodians of records is responsible for ensuring compliance with the confidentiality and access provisions of this policy and these administrative regulations.

G. SECURITY OF RECORDS

Confidential, cumulative, health, and pupil personnel records will be stored in a locked container or locked room.

Appendix A

Notification of Rights Under FERPA for Elementary and Secondary Institutions

The Family Educational Rights and Privacy Act (FERPA), 20 U.S.C. § 1232g, et seq., affords parents and eligible students (i.e., students over 18, emancipated minors, and those attending post-secondary educational institutions) certain rights with respect to the student's education records. They are:

(1) The right to inspect and review the student's education records within forty-five (45) calendar days of the day the school district receives a request for access.

Parents or eligible students should submit to the school principal a written request that identifies the record(s) they wish to inspect. The principal will make arrangements for access and notify the parents or eligible student of the time and place where the records may be inspected.

(2) The right to request the amendment of the student's education records that the parents or eligible student believe are inaccurate or misleading, or otherwise violate the student's privacy rights.

Parents or eligible students who wish to ask the school district to amend a record should write the school principal clearly identify the part of the record the parents or eligible student want changed, and specify why it should be changed. If the school district decides not to amend the record as requested by the parents or eligible student, the District will notify the parents or eligible student of the decision and advise them of their right to a hearing regarding the request for amendment. Additional information regarding the hearing procedures will be provided to the parents or eligible student when notified of the right to a hearing.

(3) The right to privacy of personally identifiable information in the student’s education records, except to the extent that FERPA authorizes disclosure without consent.

One exception that permits disclosure without consent is disclosure to a school official with legitimate interests. A school official is a person employed by the Board as an administrator, supervisor, instructor or support staff member (including health or medical staff and law enforcement unit personnel); or a person or company with whom the Board has outsourced services or functions it would otherwise use its own employees to perform (such as an attorney, auditor, medical consultant, or therapist). A school official has a legitimate educational interest if the official needs to review an education record in order to fulfill his or her professional responsibility.

Upon request, the school district discloses a student's education record without consent to officials of another school, including other public schools, charter schools, and post-secondary institutions, in which the student seeks or intends to enroll, or is already enrolled if the disclosure is for purposes of the student’s enrollment or transfer.

(4) The right to file a complaint with the U.S. Department of Education concerning alleged failures by the District to comply with the requirements of FERPA. The name and address of the agency that administers FERPA is:

Family Policy Compliance Office

U.S. Department of Education

400 Maryland Avenue, S.W.

Washington, DC 20202-4605

Unless notified in writing by a parent or eligible student to the contrary within two weeks of the date of this notice, the school district will be permitted to disclose "Directory Information" concerning a student, without the consent of a parent or eligible student. Directory Information includes information contained in an education record of a student that would not generally be considered harmful or an invasion of privacy if disclosed. It includes, but is not limited to, the parent’s name, address, the student’s name, address, telephone number, photographic, computer and/or video images, major field(s) of study, grade level, enrollment status (full-time; part-time), participation in school-sponsored activities or athletics, weight and height (if the student is a member of an athletic team), dates of attendance, degrees, honors and awards received, and the most recent previous school(s) attended. Directory information does not include a student’s social security number, student identification number or other unique personal identifier used by the student for purposes of accessing or communicating in electronic systems unless the identifier cannot be used to gain access to education records except when used in conjunction with one or more factors that authenticate the user’s identity, such as a PIN or password.

The school district may disclose directory information about students after they are no longer in enrollment in the Hamden Public Schools. Notwithstanding the foregoing, the school district will continue to honor any valid objection to the disclosure of directory information made while a student was in attendance unless the student rescinds the objection.

An objection to the disclosure of directory information shall not prevent the school district from disclosing or requiring a student to disclose the student’s name, identified or institutional email address in a class in which the student is enrolled.

The written objection to the disclosure of directory information shall be good for only one school year. The school district is legally obligated to provide military recruiters and institutions of higher learning, upon request, with the names, addresses and telephone numbers of secondary school students, unless the secondary student or the parent of the student objects to such disclosure in writing. Such objection shall be in writing and shall be effective for one school year. In all other circumstances, information designated as directory information will not be released when requested by a third party unless the release of such information is determined by the administration to be in the educational interest of the school district and is consistent with the district’s obligations under both state and federal law

DENIAL OF PERMISSION TO RELEASE DIRECTORY INFORMATION

The school district is permitted to disclose "Directory Information" concerning a student, without the consent of a parent or eligible student unless notified annually in writing by a parent or eligible student to the contrary. The primary purpose of directory information is to allow Hamden Public Schools to include information from your child’s education records in certain publications. Examples include, but are not limited to, the following: a playbill, showing your student’s role in a drama production; yearbook; honor roll; graduation programs; and sports activity sheets.

Directory Information includes information contained in an education record of a student that would not generally be considered harmful or an invasion of privacy if disclosed. It includes, but is not limited to, the parent’s name, address, the student’s name, address, telephone number, photographic, computer and/or video images, major field(s) of study, grade level, enrollment status (full-time; part-time), participation in school-sponsored activities or athletics, weight and height (if the student is a member of an athletic team), dates of attendance, degrees, honors and awards received, and the most recent previous school(s) attended.

If you do not want the district to release specific information, please indicate below.

_____Release of all Directory Information is denied

OR, permission is denied for the following:

_____ Parent’s name

_____ Parent’s address

_____ Student’s name

_____ Student’s address

_____ Student’s telephone number

_____ Photographic, computer and/or video images

_____ Major field(s) of study

_____ Grade level

_____ Enrollment status (full-time; part-time)

_____ Participation in school-sponsored activities or athletics

_____ Weight and height (if the student is a member of an athletic team)

_____ Dates of attendance

_____ Degrees, honors and awards received

_____ Most recent previous school(s) attended

This form must be completed and returned to the school within two weeks of Hamden Public Schools’ annual notification to parents, or within two weeks of enrolling in Hamden Public Schools.

____________________________________ _____________________

Name of Student School

____________________________________ ______________________

Signature of Parent (or eligible student) Date

Release of Confidential HIV-Related Information

I hereby authorize ______________________________[name of individual who holds the information], to release confidential HIV-related information, as defined in Conn. Gen. Stat. § 19a-581, concerning ______________________________[name of protected individual], to the following personnel:

_____ 1) School Nurse

_____ 2) School Administrator(s)

a) ____________________

b) ____________________

_____ 3) Student's Teacher(s)

a) ___________________

b) ____________________

_____ 4) Paraprofessional(s)

_____ 5) Director of Pupil Personnel Services

_____ 6) Other(s)

a) ____________________

b) ____________________

This authorization shall be valid for

_____ 1) The student's stay at _________________ School.

_____ 2) The current school year.

_____ 3) Other _________________

specify period

I provide this information based on my responsibility to consent for the health care of _________________________. I understand that such information shall be held confidential by the persons authorized here to receive such information, except as otherwise provided by law.

________________________________

Name

____________________________

Relationship to Student

____________________________

Date

Transfer of Confidential Student Information

Date: ___________________

Pursuant to the Family Educational Rights and Privacy Act (“FERPA”), I hereby authorize the Hamden Public Schools to release and/or obtain the following confidential records regarding my child:

Name of Child: _____________________________________________

Address: _____________________________________________

_____________________________________________

DOB: __________________

Parent(s)/Guardian(s):_________________________________________

School: _____________________________________________

(Please check all that apply)

Obtain Release

All Records □ □

Cumulative File □ □

Pupil Personnel/Special Education □ □

Disciplinary □ □

Health/Medical* □ □

Other (please specify): □ □

_______________________________

To/From: _____________________________________________________________________

Name

Address: ________________________________ ______________________ _____________

Street Town State/Zip Code

Telephone: (_______)________________ Fax: (________)_______________________

I understand that the information to be disclosed is protected as an “education record” under FERPA, and that such information shall not be redisclosed unless permitted under FERPA. I further understand that the officers, employees, and agents of any party that receives protected information under FERPA may use such information only for purposes for which the disclosure is made.

___________________________________ ____________________

Signature of Parent/Guardian Date

___________________________________

Print Name of Parent/Guardian

*******************************************************************************

*If this authorization is being used to obtain Protected Health Information from a child’s physician or other covered entity under HIPAA, the following section must also be completed:

I, the undersigned, specifically authorize _______________________________ (Name of

Physician) to disclose my child’s medical information, as specified above, to my child’s school,

____________________________________ (Name of School), at the above address for the purposes described

here (i.e. health assessment for school entry, special education evaluation etc.):

By signing below, I agree that a photocopy of this authorization will be valid as the original. This authorization will be valid for a period of one year from the date below. I understand that I may revoke this authorization at any time by notifying the physician’s office in writing, but if I do, it will not have any effect on actions taken by the Physician prior to receiving such revocation.

I understand that under applicable law, the information disclosed under this authorization may be subject to further disclosure by the recipient and thus, may no longer be protected by federal privacy regulations.

I understand that my child’s treatment or continued treatment with any health care provider or enrollment or eligibility for benefits with any health plan may not be conditioned upon whether or not I sign this authorization and that I may refuse to sign it.

Any information received by the school pursuant to this authorization is subject to all applicable state and federal confidentiality laws governing further use and disclosure of such information.

********************************************************************************

_________________________________________ ____________________

Signature of Parent/Guardian Date

_________________________________________

Print Name of Parent/Guardian

s. Accident Reports	Cumulative File
t. Basic school entrance health histories	Cumulative/Health File
u. Cumulative Health Record (CHR-1, original or copy)	Health File (*copy remains with district/original follows student)
v. Individualized Health Care Plans/ Emergency Care Plans	Cumulative/Health/Pupil Personnel File
w. Health Assessment Records (HAR-3)	Health File
x. Incident Reports	Cumulative File
y. Medication administration records(*6 yrs OR until superseded by yearly summary on	Health File
z. Parent authorization for medications/treatments	Health File
aa. Physician's orders for medications treatments	Health File
bb. Referral forms for services based on results of mandated screenings	Health/Pupil Personnel File
cc. Sports histories and physical-examination reports	Health FIle
dd. Nursing Records (Health assessment data; Nursing process notes; 3rd party health	Health File
ee. Section 504 Records	Health File

C. CATEGORY "C" RECORDS -SPECIAL EDUCATION

1.   category C includes verified information necessary for the formulation of prescriptive educational plans designed to meet the unique needs of selected students.
2.   Category C information should be kept separate from the student's cumulative folder, in the Pupil Personnel File.
3.   Category C records must be maintained for at least six (6) years after the student leaves the school district or graduates from high school.
4.   Prior to the destruction of Category C information, notification to parents and/or eligible students via media will be made and opportunity provided to copy said
records.

Category C shall include (where applicable):

RECORD	LOCATION
a. PPT referral forms	Pupil Personnel File
b. School counselor case records	Cumulative/Pupil Personnel File
c. School psychologists case records	Cumulative/Pupil Personnel File
d. School social-work case records	Cumulative/Pupil Personnel File
e. School speech/language pathology case records	Cumulative/Pupil Personnel File
g. Special Education assessment/ evaluation reports	Pupil Personnel File
h. Due process records (including complaints, mediations, and hearings)	Pupil Personnel File
I. Individual Transition Plan	Pupil Personnel File
j. Individualized Education Program (''IEP'') Records	Pupil Personnel File
k. Planning and Placement Team (''PPT") records (including notices, meetings, consent forms)	Pupil Personnel File
I. Individualized Family Service Plans (''IFSPs'')	Pupil Personnel File

D. CATEGORY "D" RECORDS

1. Category D records must be maintained for minimum retention period specified below.

Category "D" shall include (if applicable):

RECORD	MINIMUM RETENTION REQUIRED	Cumulative File
a. Sports - Contract/Student Contract (including signature sheet for student handbook)	End of school year in which signed	Cumulative File
b. Permission slips/ waivers	3 years	Cumulative File
c. Free/reduced meal application and documentation	3 years	Cumulative File
d. Annual Notification to Parents (Student behavior and Discipline, Bus Conduct, Electronic Communications Systems, and the National School Lunch Program)	1 year	Cumulative File
e. Adult education Registration Records	3 years or until audited, whichever comes first	Cumulative File
f. After school program registration records	1 year	Cumulative File
g. Pesticide application notification registration form	5 years	Cumulative File
h. School registration records including residency documentation	3 years or until audited, whichever comes later	Cumulative File
i. Student portfolio work (student produced work for grading assessment)	End of year in which student received grade	May be Maintained by Individual Teachers
j. Tardy slips from parents/guardians	End of School year	Cumulative File
k. Physician's Standing orders	Permanent; revise as required. Keep old copy separately.	Health File
I. Student's emergency information card	Until superseded or student leaves school district.	Cumulative/Health File
m. Test Protocols	Discretion of district.	Cumulative/Pupil Personnel File
n. Surveillance videotapes 2 weeks made on school bus (*if maintained by district)	2 weeks	N/A
o. Log of access to education records	Maintained for same retention period as required for the record	Cumulative/Health/Pupil Personnel

E. DURATION OF EDUCATION RECORDS

1.   Records shall be destroyed in accordance with district policy and the
Records Retention Schedule of the Public Records Administrator.
2.   Records may be maintained for longer periods of time whenever valid
cause for the retention of records is shown to the custodian of records.
3.   Notwithstanding the applicable retention schedule, the school district shall not destroy any education record if a parent or eligible student has an
outstanding request to inspect and review the education record.

F. RESPONSIBILITY FOR MAINTENANCE OF EDUCATION RECORDS

1.   The Superintendent is the Chief Custodian of Records.
2.   In addition, the following personnel are designated as the guardians of
records for each of the schools:
a.   Categories A, B & D: Building Principals
b.   Category C: Director of Special Education
c. With respect to confidential HIV-related information, the Nurse shall be the guardian of records. With respect to child abuse and neglect
investigation material, the Principal at each school shall be the guardian of the records.
3.   The Superintendent will annually list for public inspection the names and positions of the custodians of records in each of the schools.
4.   Each of the custodians of records shall supply parents, on request, a list of the types and locations of education records collected, maintained, or used within the school district.
5. The custodians of records is responsible for ensuring compliance with the confidentiality and access provisions of this policy and these administrative regulations.

G.SECURITY OF RECORDS

Confidential, cumulative, health, and pupil personnel records will be stored in a locked container or locked room.

Regulation Revised: May 2018

Appendix A

Notification of Rights Under FERPA for Elementary and Secondary
Institutions

The Family Educational Rights and Privacy Act (FERPA), 20 U.S.C. § 1232g, et
seq., affords parents and eligible students (i.e., students over 18, emancipated minors, and those attending post-secondary educational institutions) certain rights with respect to the student's education records. They are:

(1} The right to inspect and review the student's education records within
forty-five (45} calendar days of the day the school district receives a request for access.

Parents or eligible students should submit to the school principal a written
request that identifies the record(s) they wish to inspect. The principal will make
arrangements for access and notify the parents or eligible student of the time and place where the records may be inspected.

(2} The right to request the amendment of the student's education records
that the parents or eligible student believe are inaccurate or misleading, or otherwise violate the student's privacy rights.

Parents or eligible students who wish to ask the school district to amend a record should write the school principal clearly identify the part of the record the parents or
eligible student want changed, and specify why it should be changed. If the school
district decides not to amend the record as requested by the parents or eligible student, the District will notify the parents or eligible student of the decision and advise them of their right to a hearing regarding the request for amendment. Additional information
regarding the hearing procedures will be provided to the parents or eligible student
when notified of the right to a hearing.

(3) The right to privacy of personally identifiable information in the student's education records, except to the extent that FERPA authorizes disclosure without
consent.

Upon request, the school district discloses a student's education record without
consent to officials of another school, including other public schools, charter schools, and post-secondary institutions, in which the student seeks or intends to enroll, or is already enrolled if the disclosure is for purposes of the student's enrollment or transfer.

(4) The right to file a complaint with the U.S. Department of Education
concerning alleged failures by the District to comply with the requirements of FERPA. The name and address of the agency that administers FERPA is:

Family Policy Compliance Office
U.S. Department of Education
400 Maryland Avenue, S.W.
Washington, DC 20202-4605

Unless notified in writing by a parent or eligible student to the contrary within
two weeks of the date of this notice, the school district will be permitted to disclose
"Directory Information" concerning a student, without the consent of a parent or eligible student. Directory Information includes information contained in an education record of a student that would not generally be considered harmful or an invasion of privacy if disclosed. It includes, but is not limited to, the parent's name, address, the student's name, address, telephone number, photographic, computer and/or video images, major field(s) of study, grade level, enrollment status (full-time; part-time), participation in school-sponsored activities or athletics, weight and height (if the student is a member of an athletic team}, dates of attendance, degrees, honors and awards received, and the most recent previous school(s) attended. Directory information does not include a student's social security number, student identification number or other unique personal identifier used by the student for purposes of accessing or communicating in electronic systems unless the identifier cannot be used to gain access to education records except when used in conjunction with one or more factors that authenticate the user's identity, such as a PIN or password.

The school district may disclose directory information about students after they are no longer in enrollment in the Hamden Public Schools. Notwithstanding the
foregoing, the school district will continue to honor any valid objection to the disclosure of directory information made while a student was in attendance unless the student rescinds the objection.

An objection to the disclosure of directory information shall not prevent the
school district from disclosing or requiring a student to disclose the student's name,
identified or institutional email address in a class in which the student is enrolled.

The written objection to the disclosure of directory information shall be good for only one school year. The school district is legally obligated to provide military
recruiters and institutions of higher learning, upon request, with the names, addresses and telephone numbers of secondary school students, unless the secondary student or the parent of the student objects to such disclosure in writing. Such objection shall be in writing and shall be effective for one school year. In all other circumstances, information designated as directory information will not be released when requested by a third party unless the release of such information is determined by the administration to be in the educational interest of the school district and is consistent with the district's obligations under both state and federal law.

DENIAL OF PERMISSION TO RELEASE DIRECTORY INFORMATION

The school district is permitted to disclose "Directory Information" concerning a student, without the consent of a parent or eligible student unless notified annually in writing by a parent or eligible student to the contrary. The primary purpose of directory information is to allow Hamden Public Schools to include information from your child's education records in certain publications. Examples include, but are not limited to, the following: a playbill, showing your student's role in a drama production; yearbook; honor roll; graduation programs; and sports activity sheets.

Directory Information includes information contained in an education record of a student that would not generally be considered harmful or an invasion of privacy if disclosed. It includes, but is not limited to, the parent's name, address, the student's name, address, telephone number, photographic, computer and/or video images, major field(s) of study, grade level, enrollment status (full-time; part-time), participation in school-sponsored activities or athletics, weight and height (if the student is a member of an athletic team), dates of attendance, degrees, honors and awards received, and the most recent
previous school(s) attended.

If you do not want the district to release specific information, please indicate below.

__ Release of all Directory Information is denied

OR, permission is denied for the following:

__ Parent's name
__ Parent's address
__ Student's name
__ Student's address
__ Student's telephone number
__ Photographic, computer and/or video images
__ Major field(s) of study
__ Grade level
__ Enrollment status (full-time; part-time)
__ Participation in school-sponsored activities or athletics
__ Weight and height (if the student is a member of an athletic team)
__ Dates of attendance
__ Degrees, honors and awards received
__ Most recent previous school(s) attended

This form must be completed and returned to the school within two weeks of Hamden Public Schools' annual notification to parents, or within two weeks of enrolling in Hamden Public Schools.

RELEASE OF CONFIDENTIAL HIV-RELATED INFORMATION

_____ 1) School Nurse

_____ 2) School Administrator(s)

a) ____________________

b) ____________________

_____ 3) Student's Teacher(s)

a) ____________________

b) ____________________

_____ 4) Paraprofessional(s)

_____ 5) Director of Pupil Personnel Services

_____ 6) Other(s)

a) ____________________

b) ____________________

This authorization shall be valid for

_____ 1) The student's stay at _________________ School.

_____ 2) The current school year.

_____ 3) Other _________________

specify period

________________________________

Name

____________________________

Relationship to Student

____________________________

Date

TRANSFER OF CONFIDENTIAL STUDENT INFORMATION

Date: ___________________

Name of Child: _____________________________________________

Address: _____________________________________________

_____________________________________________

DOB: __________________

Parent(s)/Guardian(s):_________________________________________

School: _____________________________________________

(Please check all that apply)

Obtain Release

All Records □ □

Cumulative File □ □

Pupil Personnel/Special Education □ □

Disciplinary □ □

Health/Medical* □ □

Other (please specify): □ □

_______________________________

To/From: _______________________________________________________________________

Name

Address: ________________________________ ______________________ _______________

Street Town State/Zip Code

Telephone: (_______)________________ Fax: (________)_______________________

___________________________________ ____________________

Signature of Parent/Guardian Date

___________________________________

Print Name of Parent/Guardian

*******************************************************************************

*If this authorization is being used to obtain Protected Health Information from a child’s physician or other covered entity under HIPAA, the following section must also be completed:

I, the undersigned, specifically authorize _______________________________ to disclose my

Name of Physician

child’s medical information, as specified above, to my child’s school,

____________________________________, at the above address for the purposes described

Name of School

here (i.e. health assessment for school entry, special education evaluation etc.):

________________________________________________________________________________

Any information received by the school pursuant to this authorization is subject to all applicable state and federal confidentiality laws governing further use and disclosure of such information.

********************************************************************************

_________________________________________ ____________________

Signature of Parent/Guardian Date

_________________________________________

Print Name of Parent/Guardian

___________________________________ _____________________
Name of Student School

___________________________________ _____________________
Signature of Parent (or eligible student) Date

Personnel - Certified and Non-Certified - Series 4000

PPS Staff Resources

Elementary and Secondary Curricula

For Families

5125 - Student Records; Confidentiality (Regulation)

REGULATIONS REGARDING CLASSIFICATION OF EDUCATION RECORDS

Appendix A

Release of Confidential HIV-Related Information

Transfer of Confidential Student Information

Appendix A

DENIAL OF PERMISSION TO RELEASE DIRECTORY INFORMATION

TRANSFER OF CONFIDENTIAL STUDENT INFORMATION