skip to main content
UTRGV

The University of Texas Rio Grande Valley

Main Menu
Donate Now Directory myUTRGV

You are here:

Forms Consent to Release Student Information

Student Accessibility Services Office of Student Life and the Dean of Students

  • Home
  • Students
    • Students New to SAS
    • Student FAQ
    • Current SAS Students
    • Student Testimonials
    • Documentation Guidelines
      • Attention-Deficit/Hyperactivity Disorders (ADHD)
      • Autism Spectrum Disorders (ASD)
      • Blind & Low Vision
      • Deaf & Hard of Hearing
      • Learning Disabilities (LD)
      • Physical or Medical Disabilities
      • Psychological Disabilities
      • Traumatic Brain Injuries (TBI)
      • Temporary Disabilities
    • mySAS
  • Faculty
    • Faculty Fast Facts
    • Accommodations Glossary
    • Faculty FAQ
    • Best Practices
  • Forms
    • Presentation Request Form
    • Interpreter/CART Request Form
    • Testing Request by Faculty
    • Testing Request by Student
    • Semester Registration
    • Consent to Release Student Information
    • SAS Acknowledgements
    • Authorization to Release Student Information to SAS
    • Alternate Format Request
    • New Student Registration Form
  • About
    • Accessibility Awareness Events
    • Accessible Design
    • Staff Directory
    • Accessibility Achievement Award Home
  • Procedural Guidelines
    • Disability Laws
    • Eligibility
    • Documentation Guidelines
    • Departmental Review Committee (DRC)
    • Accommodations
    • Services
    • Study Abroad
    • Service Animals/Emotional Support Animals
    • Personal Care Attendants
    • Grievance Procedures/Records
    • Online Notice
    • Institutional Accessibility Services
  • Pregnancy and Parenting
    • Pregnancy and Parenting FAQ

Registration and Requests Forms - Related Links

  • Presentation Request Form
  • Interpreter/CART Request Form
  • Testing Request by Faculty
  • Testing Request by Student
  • Semester Registration
  • Consent to Release Student Information
  • SAS Acknowledgements
  • Authorization to Release Student Information to SAS
  • Alternate Format Request
  • New Student Registration Form

Contact Us

Student Accessibility Services

Brownsville - BMSLC 1.107
Ph. 956-882-7374, Fax 956-882-7861

Edinburg - University Center 108
Ph. 956-665-7005, Fax 956-665-3840


Email: ability@utrgv.edu
Facebook

Quick Links

Counseling Center Learning Center Military & Veterans Success Center Student Health Services Writing Center Thrive Guide Dream College Disability Scholarships Texas Workforce Commission - Vocational Rehabilitation VAIL - Center for Independent Living

Consent to Release Student Information

The Family Educational Rights and Privacy Act (FERPA) protects the privacy of your education records. Student Accessibility Services (SAS) takes all appropriate steps to comply with FERPA. With limited exceptions, SAS needs your consent before it can release information from your student education records. One notable exception is that the law allows SAS to disclose information from your education records, without consent, to school officials with a legitimate educational interest.

If you would like SAS to disclose information about you to individuals or agencies outside the University, please complete the following:

This consent does not cover records received from the UTRGV Counseling Center. Those records must be requested directly from that office.

In signing below, I understand that the above information may be released orally or in the form of copies of written records, as preferred by the requestor. I have a right to inspect any written records released pursuant to this Consent (except for parent’s financial records and certain letters of recommendation for which the student waived inspection rights). I may revoke this Consent by written request. Signed,

true
FERPA Privacy Format: First Name
true
Format: Last Name
true
Format: UTRGV ID Number
true
Format: John.Smith@utrgv.edu
true
I, hereby grant my consent to SAS to provide information from my SAS records to:


true
true
true
true
true
The type of information that may be released under this consent is as follows:


true
true
Jump to Top
UTRGV
  • Twitter
  • Facebook
  • LinkedIn
  • YouTube
  • CARES Act Reporting
  • Site Policies
  • Contact UTRGV
  • Required Links
  • Fraud Reporting
  • Senate Bill 18 Reporting
  • UTRGV Careers
  • Clery Act Reports
  • Web Accessibility
  • Mental Health Resources
  • Sexual Misconduct Policy
  • Reporting Sexual Misconduct