Student Record Request Template

This template is used by parents or guardians to formally request access to and copies of a student’s educational records from a school district. It ensures compliance with relevant federal and state laws, including the Family Educational Rights and Privacy Act (FERPA) and the Individuals with Disabilities Education Act (IDEA).

  1. Contact Information: Includes the name of the school official and their email address.
  2. Date: The date the request is made.
  3. References applicable laws (state statute, FERPA, IDEA) and specifies the records being requested, including:
    1. General educational records for the named student.
    2. Progress reports, report cards, correspondence, and notes.
    3. Records with personally identifiable information about the student.
    4. Student work products and classroom assignments.
    5. Documentation of interactions with third-party service providers.
    6. Notes from meetings and standardized testing results.
    7. Attendance records, disciplinary notices, and health records.
    8. Emails and communications related to the student.
  4. Records related to LGBTQ+ issues, including club participation and materials shared with the student.
  5. Preservation Request: Requests immediate steps to preserve all relevant records.
  6. Scope of Request: Specifies that the request covers all records held by various school personnel and departments.
  7. Delivery Method: Requests electronic copies of all documents.
  8. Waiver Request: Requests a waiver of copying costs due to potential hardship.
  9. Parental Rights: Asserts parental rights to direct the medical and mental health decisions for their child and requests citations of any laws that might override these rights.

This template can be used by parents or guardians when they need comprehensive access to their child’s educational records for purposes such as reviewing academic progress, monitoring compliance with an IEP, or addressing concerns about the child’s educational environment or services received. It is particularly useful for ensuring that all relevant records are collected from various sources within the school district and that parents’ legal rights are respected.

Student Record Request Template Word Document
Student Record Request Template PDF

School Official

Email:

[Date]

Dear [   ]:

Pursuant to [insert citation to applicable state statute]; the Family Educational Rights and Privacy Act , 20 U.S.C.§ 1232 (g); 34 C.F.R. Part 99 (FERPA); Individuals with Disabilities Education Act, 20 U.S.C § 1400, et seq.(IDEA), I am requesting access to, and copies of, all records under the custody and control of the __________ School District (hereinafter “District”). This request encompasses all of the education records identified below, no matter where they may be located, whether in the Central Administration Office, the Special Education Office, or any other department, office or location within the School District where education records are collected, maintained or utilized for reference by school district staff, specifically including any/all so called “sole use” files. I am formally requesting copies of the following records:

● Educational records for <STUDENT NAME> currently being maintained by _______the District;

● Progress reports, report cards, correspondence, handwritten notes to and from parents, other School District staff, memos, interoffice memos, emails, letters, of any kind, including notes of telephone calls, multi-disciplinary meeting and Individualized Education Programs (“IEP”) meeting planning notes/discussions, classroom/behavioral observations of <STUDENT NAME>, evaluations and/or assessments, testing protocols/raw data collected from student/teachers/evaluators and any District or contracted outside school psychologists in the development of multidisciplinary evaluations and reevaluations on <STUDENT NAME> behalf.

● Records/documents that (1) contain personally identifiable information concerning <STUDENT NAME> or any variation of the student’s name;

● Records referenced by student initials, social security number, student identification number or any other means.

● Documents/records that name <PARENT/GUARDIAN(S) NAME> or refer to <STUDENT NAME> guardian, parents, or otherwise;

● Student work product including writing samples, classroom-based assignments, academic tests, projects, completed written assignments/journal entries, teacher checklists, data collection logs/sheets, behavior rating scales/questionnaires, including discussions and email communications between or including the district and parents;

● Documents/records containing curricular planning information maintained by the guidance office/counselor regarding weekly, direct social skills instruction;

● Response to Intervention data and/or records;

● Documentation containing information exchanged with any and all third-party, wrap-around service providers/evaluators, including reports and/or anecdotal records;

● Draft copies and notes from multi-disciplinary team/ER review meetings and all state/district standardized PSSA testing results, IEP’s, and all data upon which progress monitoring reports are based;

● Instruction, programming and/or service progress reports and data collection  toward IEP goal mastery, including progress monitoring reports;

● Attendance records, parent/teacher conferences, and documentation of any behavioral/disciplinary notices, behavior tracking forms;

● Medical and school health records, notes of IU/District school psychologists, speech and language, and OT therapists, or other related service/resource specialists, including any outside contracted service personnel who have provided services to, evaluated or have otherwise been involved directly or indirectly in developing, maintaining or archiving the requested health records on behalf of <STUDENT NAME>;

● District staff emails relating to [Student];

● Any type of “Support Plan” that exists for <STUDENT NAME>;             ];

● Emails, text messages or other records indicating, documenting, discussing, or approving <STUDENT NAME>’s attendance at any training, meeting, student club or class (school-sponsored or not) discussing transgenderism, “gender identity,” LGBTQ+, or sexual orientation. This includes student club sign-in sheets, or membership rosters. You may redact the names of other students, but not the club or class sponsor;

● Any and all educational materials, whether officially approved curriculum or assignments, or other materials or assignments, not officially approved, that a school employee shared with <STUDENT NAME> referencing transgenderism, gender identity, LGBTQ+, or sexual orientation. For purposes of this request, “materials” also includes copies of any printed media, brochures, or digital media, including videos and/or hyperlinks to websites or digital media (such as YouTube), that a District employee or volunteer shared with or showed to <STUDENT NAME>;

● Any text messages, emails, or social media site “instant messages” (whether on a school device or on a personal device) sent to <STUDENT NAME>; or sent by a District employee to anyone else concerning <STUDENT NAME>;

● Documents containing the name and contact information of any third-party organization a District employee i) shared with < STUDENT NAME>; or ii) to which a District employee referred <      STUDENT NAME>;.

● Documents containing or referencing the name and contact information of any third-party organization a district employee consulted regarding <STUDENT NAME>, including any gender-transition advocacy organizations or medical clinics.

I am further requesting you take immediate steps to preserve all records responsive to this request..

This requests includes all records in possession, custody and/or control of the central District office; the principal’s office; the homeroom teacher; school or district guidance counselor(s); school psychologist(s); LGBT/GSA or other club supervising teacher(s); or other school employees, including all so called “sole use” documents and/or files. In your response, please indicate whether any District personnel employed in the foregoing specifically referenced positions were queried as to the existence of responsive records.

Please send electronic copies of all responsive documents to the email address provided herein. If there is a district policy governing the cost of copying documents, we request that cost be waived due to the hardship it would cause resulting in prevention of <PARENT/GUARDIAN NAME> to fully participate in <STUDENT NAME>’s education and IEP.

Finally, I am aware that we have constitutionally protected parental rights to direct the medical and mental health decision making of our child.  We are not aware of any <INSERT STATE> law or statute that circumvents our parental rights in such matters nor do we believe that such a law exists.  If for some reason, you are interpreting a law in such a way as to authorize you to violate our parental rights, please provide the citation and a copy of the relevant statute(s).

If you are unable to provide such a law authorizing your actions and the overriding of our parental rights, then we shall assume you are operating outside your legal authority. I look forward to reviewing whatever statues you would like to provide within one week

Thank you for your anticipated cooperation in this matter.

​​​​​Sincerely,

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CC VIA EMAIL:

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