Statewide School Support Referral Form

Authorization to release information (one form per student) must be signed by the parent / guardian and received by Statewide School Support Services prior to scheduling a visit. Please scan and email the completed form to [email protected] with "Authorization to Release" in the subject line.

Authorization Form

Formulario de Autorización

I. Requestor Information

II. Supervisor Information

IV. Interpreter Contact Information