VTA - Access Card

Please complete the "Personal Data Card , Certification and Authorization for Release of Protected Health Information" form, and return to your student's Case Manager.

Your Adult Student must sign the form if they are over 18 years old or are not conserved.

Conservators must sign the form for students who are conserved and include a copy of the conservatorship paperwork.

DO NOT MAIL DIRECTLY TO THE VTA OFFICE

Please contact your student's teacher directly with any questions.