Care Notebook: A Quick Guide

What is a Care Notebook?

A Care Notebook is an organizing tool for families who have children with special health care needs.

Use a Care Notebook to keep track of important information about your child’s health and care.

How can a Care Notebook help me?

In caring for your child with special health needs, you may get information and paperwork from many sources. A Care Notebook helps you organize the most important information in a central place. A Care Notebook makes it easier for you to find and share key information with others who are part of your child’s care team.

Use your Care Notebook to:

* Track changes in your child’s medicines or treatments
* List telephone numbers for health care providers and community organizations
* Prepare for appointments
* File information about your child’s health history
* Share new information with your child’s primary doctor, public health or school nurse, daycare staff, and others caring for your child.
* What are some helpful hints for using my child’s Care Notebook?
* Store the Care Notebook where it is easy to find. This helps you and anyone who needs information in your absence.
* Add new information to the Care Notebook whenever there is a change in your child’s treatment.
* Consider taking the Care Notebook with you to appointments and hospital visits so that information you need will be close at hand.

How do I set up my child’s Care Notebook?

Follow these steps to set up your child’s notebook:

Step 1: Gather information you already have.

* Gather up any health information you already have about your child. This may include reports from recent doctor’s visits, immunization records, recent summary of a hospital stay, this year’s school plan, test results, or informational pamphlets.

Step 2: Look through the pages of the Care Notebook.

* Which of these pages could help you keep track of information about your child’s health or care
* Choose the pages you like. Print copies of any that you think you will use. The Care Notebook pages are available from the Internet at http://www.cshcn.org. Go to Resources and then choose Care Organizing Tools.?

Step 3: Decide which information about your child is most important to keep in the Care Notebook.

* What information do you look up often?
* What information is needed by others caring for your child?
* Consider storing other information in a file drawer or box where you can find it if needed.

Step 4: Put the Care Notebook together.

* Everyone has a different way of organizing information. The only important thing is to make it easy for you to find again. Here are some suggestions for supplies used to create a Care Notebook:
* 3-ring notebook or large accordion envelope. Hold papers securely.
* Tabbed dividers. Create your own information sections.
* Pocket dividers. Store reports.
* Plastic pages. Store business cards and photographs.

CARE NOTEBOOK CHILDREN’S HOSPITAL AND REGIONAL MEDICAL CENTER, SEATTLE, WASHINGTON Printer 6/03 WASHINGTON STATE DEPARTMENT Of HEALTH, CHILDREN WITH SPECIAL HEALTH CARE NEEDS PROGRAM

Care Notebook
List of Pages
Pages to Keep Track of Appointments and Care
* Appointment Log
* Diet Tracking Form
* Emergency Information Form
* Equipment/Supplies
* Growth Tracking Form
* Hospital Stay Tracking Form
* Lab Work/Tests/Procedures
* Make-a-Calendar
* Medical Bill Tracking Form
* Medical/Surgical Highlights
* Medications
* Notes Pages to Create a Care Summary: Abilities and Special Care Needs
* Activities of Daily Living
* Care Schedule
* Child’s Page – Now and Later
* Communication
* Coping/Stress Tolerance – Mobility
* Nutrition
* Respiratory
* Rest/Sleep
* Social/Play
* Transitions – Looking Ahead Pages to Create a Care Team and Resources List
* Children’s Hospital and Regional Medical Center Community Health Care/Service Providers:
* Medical/Dental
* Public Health
* Home Care
* Therapists
* Early Intervention Services
* School
* Child Care
* Respite Care
* Pharmacy
* Special Transportation
* Family Information
* Family Support Resources
* Funding Sources
* Alphabet Soup Acronym Index

CARE NOTEBOOK CHILDREN’S HOSPITAL AND REGIONAL MEDICAL CENTER, SEATTLE, WASHINGTON Printer 6/03 WASHINGTON STATE DEPARTMENT Of HEALTH, CHILDREN WITH SPECIAL HEALTH CARE NEEDS PROGRAM

FAMILY RIGHTS AND PRIVACY ACT [FERPA]

Educational records of students in the United States are safeguarded by policies of the federal legislation entitled the Family Education Rights and Privacy Act of 1974.

Educational records are defined as any information concerning a student which is maintained in writing, on print, film, or tape for others to see or hear.

The schools should maintain the following educational records:

1. The ?CA-60? is an educational record, which follows the student from kindergarten through graduation. It contains grades, test scores, attendance records, schools attended, health information, etc. Each student has a CA-60.

2. The Personal Cumulative File includes evaluative material on students with disabilities, psychiatric reports, records of some disciplinary matters, etc.

3. Administrative files are kept in the normal course of school business. Information regarding students is maintained on a regular basis (e.g., requests from parents that their child be allowed to attend a school out of their attendance area).

4. Parents (and students when they turn age 18) may have access to the student’s educational records.

Parents who are divorced or separated may have access to their child’s records unless specifically prohibited by a court order on file at the child’s school.

Parents and or eligible students wishing to read a child’s educational records should contact the principal’s office. Access to personal cumulative records can be arranged by contacting the special education office.

School personnel have access to the CA-60 records in the course of their normal duties. Teachers and other professionals have access to personal cumulative files when there is a need verified by an administrator responsible for the file.

Information from the files will be given to others under the following conditions.

1. Parents or eligible students may request that information be released to specific parties or organizations.

2. When a student enrolls in another school, the appropriate parts of records may be forwarded upon the request of the receiving school.

In addition, federal regulations allow school districts to publish certain information without securing specific authorization each time if parents, guardians, and/or eligible students are informed in advance that this information will be released. If they do not want such information made public, the principal should be informed and the information will be withheld. That information includes:

1. Student name
2. Field of study
3. Participation in recognized activities and sports
4. Weight and height of athletic members
5. Photographs
6. Awards received
7. Sex of pupil

Parents or eligible students, who believe that an educational record is inaccurate or misleading, or violates the student’s rights, may request in writing that the records be amended or destroyed. If the request is refused, the parents or eligible student has a right to a hearing.

Parents or eligible students also have the right to file a complaint with the U.S. Department of Education concerning an alleged failure of the school district to comply with the federal ?Family Education Rights and Privacy Act of 1974.?

The federal government maintains an office which will assist. The mailing address is Department of Education Switzer Building, Room 4512, Washington, D.C. 20202.

RespectAbility Law Center, Copyright 2004

Overview of FERPA

The Family Educational Rights and Privacy Act gives parents the right to inspect, review and amend their child’s education records and protects those records from nonconsensual disclosure to third parties. Whether a particular item of information about a student is protected by FERPA depends on whether or not it meets the statute’s definition of an “education record.”

Key Points

STATUTORY DEFINITION

Apart from specifically enumerated exceptions, education records under FERPA are those records that are: (1) directly related to a student; and (2) maintained by an education agency or institution or by a party acting for the agency or institution. 20 USC 1232g(a)(4)(A); 34 CFR 99.3. The IDEA incorporates FERPA’s definition. 34 CFR 300.560. Education records may be recorded in any manner, including, but not limited to, handwriting, print, computer media, video or audio tape, film, microfilm or microfiche.

INFORMATION DIRECTLY RELATED TO A STUDENT

There is no statutory definition of the term “information directly related to a student.” Many experts have suggested that it should be considered synonymous with “personally identifiable information” under 34 CFR 99.3, which includes, but is not limited to:

1. The student’s name.
2. The name of the student’s parent(s) or other family member.
3. The address of the student or student’s family
4. A personal identifier, such as the student’s social security number or student number.
5. Other information that would make the student’s identity easily traceable.

MAINTAINED BY EDUCATIONAL AGENCY

The designation of a document as an education record depends on who maintains it, not who originates it. 34 CFR 99.3. Documents that are maintained by a district employee or agent also qualify as education records, including those documents stored by the school’s attorney, who is considered an agent of his or her client. Note, however, that even if documents maintained by the attorney contain information directly related to the student, they may be shielded from disclosure to parents by applicable
laws relating to the attorney-client privilege or to the attorney work-product doctrine.

STATUTORY EXCEPTIONS

FERPA specifically excludes several types of records from consideration as education records, even though they may contain information directly related to a student and may be maintained by the educational agency. 34 CFR 99.3. The exceptions are:

1. Records that are kept in the sole possession of the maker, are used only as a personal memory aid, and are not accessible or revealed to any other person except a temporary substitute for the maker of the record. See Owasso Indep. Sch. Dist. No. I-011 v. Falvo, 36 IDELR 62 (U.S. 2002).

2. Records maintained by a law enforcement unit of the educational agency or institution that were created by that unit for the purpose of law enforcement.

3. In the case of persons who are employed by an educational agency or institution but who are not in attendance there, records made and maintained in the normal course of business that relate exclusively to such person in his or her capacity as an employee and that are not available for use for any other purpose.

4. Records of a student who is 18 years of age or older, or is attending an institution of postsecondary education, which are made or maintained by a physician, psychiatrist, psychologist, or other recognized professional or paraprofessional acting in such capacity, or used only in connection with the provision of treatment to the student, and are not available to anyone other than persons providing such treatment.

5. Records that only contain information about an individual after he or she is no longer a student at the agency or institution.

ITEMS NOT CONSIDERED EDUCATION RECORDS

Documents that do not meet FERPA’s definition of education records or that are encompassed by one of the statutory exceptions to that definition are not available for parental inspection and are not protected from disclosures to third parties.

IEPs

IEPs are considered protected education records for purposes of FERPA because they contain information about a student and are maintained by the educational agency or institution. Letter to Cossey, 211 IDELR 351 (OSEP 1984).

DUE PROCESS HEARING DECISIONS

It is customary that the decisions of both state and local hearing officers (including review officers and appellate panels) become part of a student’s education record, subject to the requirements and protections of FERPA. Letter to Kudwa, 211 IDELR 89 (OSEP 1979). However, written or electronic versions of the administrative decision must be made available to the public under 20 USC 1415(h)(4), although the names of the students and parents are redacted in accordance with the IDEA’s
confidentiality of data provisions. 20 USC 1417(c).

SEA COMPLAINT INVESTIGATIONS

State educational agency complaint reports are education records subject to parental inspection, provided they identify the student by name. Letter to Shrant, 211 IDELR 253 (OSEP 1981).

The IDEA requires at 34 C.F.R. 300.562(a). “Each participating agency shall permit parents to inspect and review any education records relating to their children that are collected, maintained, or used by the agency under this part. The agency shall comply with a request without unnecessary delay, and before any meeting regarding an IEP. (b)(1) The right to inspect and review education records under this section includes the right to a response from the participating agency to reasonable requests for explanations and interpretations of the records.”

Thus the IDEA requires the parents to have access to the records, with enough time before the IEP meeting to review them, ask questions, and get a response from the school district before the IEP meeting is convened.

Access to records under IDEA

Confidentiality Of Information

§300.560 Definitions. As used in §§300.560-300.577?

(a) Destruction means physical destruction or removal of personal identifiers from information so that the information is no longer personally identifiable.

(b) Education records means the type of records covered under the definition of “education records” in 34 CFR part 99 (the regulations implementing the Family Educational Rights and Privacy Act of 1974).

(c) Participating agency means any agency or institution that collects, maintains, or uses personally identifiable information, or from which information is obtained, under Part B of the Act.§300.561 Notice to parents.

(a) The SEA (State Education Agency) shall give notice that is adequate to fully inform parents about the requirements of §300.127, including?

(1) A description of the extent that the notice is given in the native languages of the various population groups in the State;

(2) A description of the children on whom personally identifiable information is maintained, the types of information sought, the methods the State intends to use in gathering the information (including the sources from whom information is gathered), and the uses to be made of the information;

(3) A summary of the policies and procedures that participating agencies must follow regarding storage, disclosure to third parties, retention, and destruction of personally identifiable information; and

(4) A description of all of the rights of parents and children regarding this information, including the rights under the Family Educational Rights and Privacy Act of 1974 and implementing regulations in 34 CFR part 99.

(b) Before any major identification, location, or evaluation activity, the notice must be published or announced in newspapers or other media, or both, with circulation adequate to notify parents throughout the State of the activity.

§300.562 Access rights.

(a) Each participating agency shall permit parents to inspect and review any education records relating to their children that are collected, maintained, or used by the agency under this part. The agency shall comply with a request without unnecessary delay and before any meeting regarding an IEP, or any hearing pursuant to §§300.507 and 300.521-300.528, and in no case more than 45 days after the request has been made.

(b) The right to inspect and review education records under this section includes?

(1) The right to a response from the participating agency to reasonable requests for explanations and interpretations of the records;

(2) The right to request that the agency provide copies of the records containing the information if failure to provide those copies would effectively prevent the parent from exercising the right to inspect and review the records; and

(3) The right to have a representative of the parent inspect and review the records.

(c) An agency may presume that the parent has authority to inspect and review records relating to his or her child unless the agency has been advised that the parent does not have the authority under applicable State law governing such matters as guardianship, separation, and divorce.

§300.563 Record of access.

Each participating agency shall keep a record of parties obtaining access to education records collected, maintained, or used under Part B of the Act (except access by parents and authorized employees of the participating agency), including the name of the party, the date access was given, and the purpose for which the party is authorized to use the records.

§300.564 Records on more than one child.

If any education record includes information on more than one child, the parents of those children have the right to inspect and review only the information relating to their child or to be informed of that specific information.

§300.565 List of types and locations of information.

Each participating agency shall provide parents on request a list of the types and locations of education records collected, maintained, or used by the agency.

§300.566 Fees.

(a) Each participating agency may charge a fee for copies of records that are made for parents under this part if the fee does not effectively prevent the parents from exercising their right to inspect and review those records.

(b) A participating agency may not charge a fee to search for or to retrieve information under this part.

§300.567 Amendment of records at parent’s request.

(a) A parent who believes that information in the education records collected, maintained, or used under this part is inaccurate or misleading or violates the privacy or other rights of the child may request the participating agency that maintains the information to amend the information.

(b) The agency shall decide whether to amend the information in accordance with the request within a reasonable period of time of receipt of the request.

(c) If the agency decides to refuse to amend the information in accordance with the request, it shall inform the parent of the refusal and advise the parent of the right to a hearing under §300.568.

§300.568 Opportunity for a hearing.

The agency shall, on request, provide an opportunity for a hearing to challenge information in education records to ensure that it is not inaccurate, misleading, or otherwise in violation of the privacy or other rights of the child.

§300.569 Result of hearing.

(a) If, as a result of the hearing, the agency decides that the information is inaccurate, misleading or otherwise in violation of the privacy or other rights of the child, it shall amend the information accordingly and so inform the parent in writing.

(b) If, as a result of the hearing, the agency decides that the information is not inaccurate, misleading, or otherwise in violation of the privacy or other rights of the child, it shall inform the parent of the right to place in the records it maintains on the child a statement commenting on the information or setting forth any reasons for disagreeing with the decision of the agency.

(c) Any explanation placed in the records of the child under this section must?

(1) Be maintained by the agency as part of the records of the child as long as the record or contested portion is maintained by the agency; and

(2) If the records of the child or the contested portion are disclosed by the agency to any party, the explanation must also be disclosed to the party.

§300.570 Hearing procedures.

A hearing held under §300.568 must be conducted according to the procedures under 34 CFR 99.22.

§300.571 Consent.

(a) Except as to disclosures addressed in §300.529(b) for which parental consent is not required by Part 99, parental consent must be obtained before personally identifiable information is –

(1) Disclosed to anyone other than officials of participating agencies collecting or using the information under this part, subject to paragraph (b) of this section; or

(2) Used for any purpose other than meeting a requirement of this part.

(b) An educational agency or institution subject to 34 CFR part 99 may not release information from education records to participating agencies without parental consent unless authorized to do so under part 99.

(c) The SEA shall provide policies and procedures that are used in the event that a parent refuses to provide consent under this section.

§300.572 Safeguards.

(a) Each participating agency shall protect the confidentiality of personally identifiable information at collection, storage, disclosure, and destruction stages.

(b) One official at each participating agency shall assume responsibility for ensuring the confidentiality of any personally identifiable information.

(c) All persons collecting or using personally identifiable information must receive training or instruction regarding the State’s policies and procedures under §300.127 and 34 CFR part 99.

(d) Each participating agency shall maintain, for public inspection, a current listing of the names and positions of those employees within the agency who may have access to personally identifiable information.

§300.573 Destruction of information.

(a) The public agency shall inform parents when personally identifiable information collected, maintained, or used under this part is no longer needed to provide educational services to the child.the parents. However, a permanent record of a student’s name, address, and phone number, his or her grades, attendance record, classes attended, grade level completed, and year completed may be maintained without time limitation.

§300.574 Children’s rights.

(a) The SEA shall provide policies and procedures regarding the extent to which children are afforded rights of privacy similar to those afforded to parents, taking into consideration the age of the child and type or severity of disability.

(b) Under the regulations for the Family Educational Rights and Privacy Act of 1974 (34 CFR 99.5(a)), the rights of parents regarding education records are transferred to the student at age 18.

(c) If the rights accorded to parents under Part B of the Act are transferred to a student who reaches the age of majority, consistent with §300.517, the rights regarding educational records in §§300.562-300.573 must also be transferred to the student. However, the public agency must provide any notice required under section 615 of the Act to the student and the parents.

§300.575 Enforcement.

The SEA shall provide the policies and procedures, including sanctions that the State uses to ensure that its policies and procedures are followed and that the requirements of the Act and the regulations in this part are met.

ASK IN WRITING FOR THIS INFORMATION!

Section 504

Access to Records

Subpart B – What Are the Rights of Inspection and Review of Education Records?

§ 99.10 What rights exist for a parent or eligible student to inspect and review education records?

(a) Except as limited under § 99.12, a parent or eligible student must be given the opportunity to inspect and review the student’s education records. This provision applies to –

(1) Any educational agency or institution; and

(2) Any State educational agency (SEA) and its components.

(i) For the purposes of subpart B of this part, an SEA and its components constitute an educational
agency or institution.

(ii) An SEA and its components are subject to subpart B of this part if the SEA maintains education records on students who are or have been in attendance at any school of an educational agency or institution subject to the Act and this part.

(b) The educational agency or institution, or SEA or its component, shall comply with a request for access to records within a reasonable period of time, but not more than 45 days after it has received the request.

(c) The educational agency or institution, or SEA or its component, shall respond to reasonable requests for explanations and interpretations of the records.

(d) If circumstances effectively prevent the parent or eligible student from exercising the right to inspect and review the student’s education records, the educational agency or institution, or SEA or its component, shall –

(1) Provide the parent or eligible student with a copy of the records requested; or

(2) Make other arrangements for the parent or eligible student to inspect and re-view the requested
records.

(e) The educational agency or institution, or SEA or its component, shall not destroy any education records if there is an outstanding request to inspect and review the records under this section.

(f) While an education agency or institution is not required to give an eligible student access to treatment records under paragraph (b)(4) of the definition of “Education records” in § 99.3, the student may have those records reviewed by a physician or other appropriate professional of the student’s choice.

(Authority: 20 U.S.C 1232g(a)(1) (A) and (B))

§ 99.11 May an educational agency or institution charge a fee for copies of education records?

(a) Unless the imposition of a fee effectively prevents a parent or eligible student from exercising the right to inspect and review the student’s education records, an educational agency or institution may charge a fee for a copy of an education record which is made for the parent or eligible student.

(b) An educational agency or institution may not charge a fee to search for or to retrieve the education records of a student.

(Authority: 20 U.S.C 1232g(a)(1)?)

§ 99.12 What limitations exist on the right to inspect and review records?

(a) If the education records of a student contain information on more than one student, the parent or eligible student may inspect and review or be informed of only the specific information about that student.

(b) A postsecondary institution does not have to permit a student to inspect and review education records that are:

(1) Financial records, including any information those records contain, of his or her parents;

(2) Confidential letters and confidential statements of recommendation placed in the education records of the student before January 1, 1975, as long as the statements are used only for the purposes for which they were specifically intended; and

(3) Confidential letters and confidential statements of recommendation placed in the student’s education records after January 1, 1975, if:

(i) The student has waived his or her right to inspect and review those letters and statements; and

(ii) Those letters and statements are related to the student’s:

(A) Admission to an educational institution;

(B) Application for employment; or

(C) Receipt of an honor or honorary recognition

(c)
(1) A waiver under paragraph (b)(3)(i) of this section is valid only if:

(i) The educational agency or institution does not require the waiver as a condition for admission to or receipt of a service or benefit from the agency or institution; and

(ii) The waiver is made in writing and signed by the student, regardless of age.

(2) If a student has waived his or her rights under paragraph (b)(3)(i) of this section, the educational institution shall:

(i) Give the student, on request, the names of the individuals who provided the letters and statements of recommendation; and

(ii) Use the letters and statements of recommendation only for the purpose for which they were intended.

(3)(i) A waiver under paragraph (b)(3)(i)of this section may be revoked with respect to any actions occurring after the revocation.

(ii) A revocation under paragraph (c)(3)(i) of this section must be in writing.

(Authority: 20 U.S.C 1232g(a)(1) (A), (B), (C), and (D))

Subpart C – What Are the Procedures for Amending Education Records?

§ 99.20 How can a parent or eligible student request amendment of the student’s education records?

(a) If a parent or eligible student believes the education records relating to the student contain information that is inaccurate, misleading, or in violation of the student’s rights of privacy, he or she may ask the educational agency or institution to amend the record.

(b) The educational agency or institution shall decide whether to amend the record as requested within a reasonable time after the agency or institution receives the request.

(c) If the educational agency or institution decides not to amend the record as requested, it shall inform the parent or eligible student of its decision and of his or her right to a hearing under § 99.21.

(Authority: 20 U.S.C 1232g(a)(2))

Sample Letter Requesting Records From School District (www.Bridges4kids.org & www.
ourchildrenleftbehind.org)
________________________________________
LETTER REQUESTING RECORDS FROM SCHOOL DISTRICT

Date

(Name of Special Education Director)
(Name of School District)
(Address of School)

Dear (Name of Special Education Director):

My child, (child’s name) [date of birth] receives special education services at (school name). Please provide me with a complete list of all education records you have on my child. Please tell me where those records are kept, and whom I should contact so I can look at them and have copies made.

If (name of schools district) has produced any written material about access to student records pursuant to the federal Family Education Rights and Privacy Act, I would request that you send me a copy of that as well.

Thank you for your help. I look forward to your prompt response.

Sincerely,

(Your name)
(Your address)
(Your telephone number)

Sample Letter Requesting Medical Records
________________________________________
LETTER REQUESTING MEDICAL RECORDS

PARENTS NAME
ADDRESS
CITY, STATE ZIP CODE
TELEPHONE NUMBER

Date

Re: Child’s name and date of birth

Dear

My son, (child’s name), is your patient. We realize that (child’s name) medical needs are on-going, and that we as his parents have an on-going obligation to be sure that he receives the best care available, regardless of where we live or work. In order for us to be best prepared to help (child’s name), we need to maintain a set of his medical records and to compile a medical resume for use with his various professional specialists, care providers and teachers.

Would you please provide us with copies of all medical records you have concerning (child’s name), from your first date of treatment to the present? We also would like to arrange that we receive copies of on-going medical records at least once every three months. What do we need to do to arrange that with you?

Thank you for understanding the need for our request and for your prompt response.

Sincerely,

PARENTS NAME
ADDRESS
CITY, STATE ZIP CODE
TELEPHONE NUMBER

Sample Letter Requesting Change in Child’s Records
________________________________________
LETTER REQUESTING A CHANGE IN CHILD’S RECORDS

Date

(Name of Special Education Director)
(Name of School District)
(Address of School)

Dear (Name of Special Education Director):

My child, (child’s name) [date of birth] attends (school name). There is a statement in (child’s name) (give name of record. For example, ?physical therapy evaluation, performed by Ms. Wormwood on June 5, 1999?) that I believe is (?misleading,? ?inaccurate,? and or ?in violation of my child’s rights?) because (give your reasons).

I request that you change (child’s name) (name of record) records so they will no longer be (misleading, inaccurate, and or in violation of my child’s rights?) because (give your reasons).

I look forward to your prompt response to this letter.

Sincerely,

(Your name)
(Your address)
(Your telephone number)

Sample FOIA Request Letter
________________________________________
FOIA REQUEST LETTER

PARENTS’ NAME
ADDRESS
CITY, STATE ZIP CODE
TELEPHONE NUMBER

Date

Pursuant to the Michigan Freedom of Information Act, please provide me with the following information, in whatever form and wherever stored:

1. Policies describing or discussing the (name of school) District’s provision of educational services in settings other than the regular or special education classroom or building.

2. Complete descriptions of services provided within the last three school years in alternative educational settings, including but not limited to, private schools, community locations and private homes.

3. Policies describing or discussing (Name of School) District criteria and implementation of providing special education services to students in alternative (non-classroom) settings.

4. Any other written or recorded information discussing or implementing non-classroom educational services of any type within the last three school years, including number of students served and identifying the service venue, without identifying individual students.

Pursuant to the fee waiver provisions of FOIA, I request that the fee for fulfilling this request be waived because the material requested is of interest to the general public; and the information will be used for the benefit of the public. If fees are not waived please advise me of any anticipated costs exceeding $50.00 so that payment arrangements can be made pending appeal of the waiver denial.

Very truly yours,
NAME
ADDRESS
CITY, STATE ZIP CODE
TELEPHONE NUMBER
Edited by: OCLB at: 9/4/03 21:33

Jimmy Kilpatrick, a national recognized professional special education advocate since 1994.

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