In order to provide quality healthcare services for Student's Full Name* at Faith Christian Academy, it is necessary to obtain medical history and current dictation. Records received will be placed in the student's health/cumulative file and will be accessible to the parent/guardian as well as designated school personnel. I hereby give Doctor's Office/Name* permission to release the following records pertaining to my child to Faith Christian Academy in order to help school personnel plan my child's care/accommodations at school: