FORM 8.961(a). ORDER AUTHORIZING ACCESS TO CHILD’S MEDICAL AND EDUCATIONAL RECORDS

FORM 8.961(A). ORDER AUTHORIZING ACCESS TO CHILD’S MEDICAL AND EDUCATIONAL RECORDS

ORDER AUTHORIZING ACCESS TO CHILD’S MEDICAL

AND EDUCATIONAL RECORDS

THIS CAUSE came on to be heard under sec. 39.402, Florida Statutes, concerning access to the medical and educational records of ...................., a child.

The Court finds

A. As to medical records and information:

..... ...................., mother/father of ..................., the child, consents to the entry of this order, and to the court’s providing access to the child’s medical records to the department, its contract agencies, and any guardian ad litem and attorney for the child, and to provide the child’s medical information to the court.

..... No parent or legal guardian of the child is available or able to consent to the entry of this order, or the parents withhold consent to providing access to the child’s medical records and/or to providing the requested medical information.

..... Access to the child’s medical records and information is necessary to provide services to the child.

B. As to educational records and information.

..... ...................., mother/father of ...................., the child, consents to the entry of this order, and to the court’s providing access to the child’s educational records to the department, its contract agencies, and any guardian ad litem and attorney for the child, and to provide the child’s educational information to the court.

..... No parent or legal guardian of the child is available or able to consent to the entry of this order, or the parents withhold consent to providing access to the child’s educational records and/or to providing the requested educational information.

..... Access to the child educational records and information is necessary to provide services to the child.

Therefore, it is ORDERED

The department, .....(name of CBC)....., its contract agencies, .....(name)....., guardian ad litem, and .....(name)....., attorney for child, are authorized to access .....(child’s name).....’s medical and educational records and information, until further order of this court.

..... This order does not address the child’s privacy rights to any of these records or information that may exist under Florida law. The child may assert to this court any objection under privacy rights to the release of this information

ORDERED on .....(date)....., in .........., .......... County, Florida

Circuit Judge

Copies to:

(Check all that apply)

..... Attorney for DCF: .....(name).....

..... Caseworker: .....(name).....

..... Guardian ad litem: .....(name).....

..... Attorney for mother: .....(name).....

..... Attorney for father: .....(name).....

..... Attorney ad litem for child: .....(name).....

..... Child named above: .....(name).....

..... Other: ....................

..... Other: ....................