DHCS (K-4) Records Request

This form can be used to request a student’s records be sent to another school.  Please note a confirmation message will display to confirm the request has been submitted, but the request can take up to 10 days to process so please plan accordingly.

In accordance with FERPA (34 CFR 99.31); this allows schools to disclose all records, including grades, health records, as well as psychological, social education or developmental information without parent consent, to the following parties: School officials with legitimate education interest; other schools to which a student is transferring; specified officials for audit or evaluation purposes; accrediting organizations; to comply with a judicial order or lawfully issues subpoena; appropriate officials in cases of health and safety emergencies; and state and local authorities, within a juvenile justice system pursuant to specific state law.

Parent's Name (required)

Parent's Email Address (required)

Phone (required)

Student's Name (required)

Enrollment Grade (required)

Birthdate (required)

Subject (required)

Please use this field to identify the following information:

- Name of school where records should be sent
- School's phone number
- School's fax number

*Note: Failure to provide all necessary information will cause a delay in the request being processed.

Identify all information that needs to be sent to the school(s) listed above. (required)

Withdrawal FormDiscipline RecordsReport CardSpecial Education Files and/or 504Health DataLEPA FilesAttendance Records