Health Professions Advisory Committee Student Evaluation Form Page 5

Date: __________________________________

Professor: Keep this for your records.

TO BE COMPLETED BY STUDENT

I understand that, according to Section 438 of the General Education Provision Act (commonly known

as the Family Education Rights and Privacy Act of 1974, as amended), students have the right to

access certain of their personal education records such as those maintained by the Health

Professions Advisory Committee. However, students may waive the right to access to confidential

recommendations maintained for the purpose of admission to graduate schools.

____________ I wish to waive the right of access to my folder in the file of the Health

Professions Advisory Committee and thus wish to have the attached form considered as a

confidential letter of recommendation.

____________ I do not wish to waive the right of access to my record and wish the

attached form to be considered as a non-confidential letter of recommendation.

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Parent category: Business