STUDENTS WITH HI V-RELATED ILLNESS EXHIBITThe University of the State of New York Education DepartmentAuthorization for Release of Confidential HIV*Related Information to the Superintendent of Schools and the Board of EducationApproved by New York State Department of HealthOC-l (6/89)Confidential HIV Related Information means any information indicating that a person had an HIV related test, or has HIV infection, HIV related illness or AIDS, or any information which could indicate that a person has been potentially exposed to HIV.
If you sign this form.
HIV related information can be given to the people listed on the form, and for the reason(s) listed on the form.
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Allowed
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ctewinkle
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