- Authorization for Exchange of Confidential Information
Updated June 2013
Student Name: _______________________________ D.O.B.: _________________
I hereby authorize the exchange of confidential information between:
_________________________________________________, Everett Public Schools, and:
Name Position
Name of person/agency: _________________________________________________
Address: ____________________________________________________________
Phone:____________________________ eMail: ____________________________
Extent and nature o...
Authorization for Exchange of Information.pdf 
