Special Education Records Request

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Parents and School Districts: Complete this Special Education Records Request, only.

Doctor, therapists, advocates, private schools, etc.: Complete this Special Education Records Request AND submit a Release to Secure Confidential Information form scanned to specialedrecords.helpdesk@bvsd.org or fax to 720-561- 5917. Below is a link to a release for that is available for your use. Please print, complete and scan or fax as indicated above.

https://drive.google.com/open?id=1OEEzY8t_1mXzj3KYA-Ps6SKfU5GCBjCm

Student First Name *

Student Middle Name: *

Student Last Name: *

Date of Birth: *

YYYY

Requester First Name: *

Requester Last Name: *

Relationship to Student: *

Email Address: *

Requesting School District (if applicable)

Home Phone Number: *

Cell Phone Number: *

Records Requested: *

Most Recent IEP

Most Recent Tri

Most Recent Behavior Support Plan

Other:

Required

Send Records via: *

Fax

US Mail

I will pick up at the BVSD Ed Center.

For Colorado Districts only: Enrich Electronic Records Transfer

Fax/Email/Address that corresponds with how you would like to receive records: *

Signature: *

Submit

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