Consent for Disclosure of Personally Identifiable Information and Immunization Information to Local and State Health Departments 

Immunizations are an important part of keeping our children healthy. School, state and local health departments must monitor immunization levels to ensure that all communities are protected from potentially life-threatening diseases and, if necessary, respond promptly to an emerging public health threat. It is important that disease threats be minimized through the monitoring of students being immunized. 

Sharing immunization and personally identifiable information including the student's name, date of birth, gender, and address with local and state health departments will keep your child safe from caring preventable diseases. The Family Educational Right and Privacy Act (FERPA), 20 U.S.C. and 1232g, requires written parental consent before personally identifiable information and immunization information from your child's education records is disclosed to the health department. If your child is 18 or over, he or she is an "eligible student" and must provide consent for disclosures of information from his or her education records. 

You may withdraw your consent to share this information in writing at any time.