HIV/AIDS Prevention & Sexual Health Opt-Out Request

Parents/guardians may use this form to excuse their child from HIV/AIDS Prevention instruction and/or Sexual Health Education (Puberty in 5th grade, CSHE in secondary). Your request will be sent to the building principal for acknowledgement.

TEACHING & LEARNING DEPARTMENT

School Year

This field is required

Student Last Name

This field is required

Student First Name

This field is required

Student ID

This field is required

Grade

This field is required

School

This field is required

Opt out of HIV/AIDS Prevention?

This field is required

Opt out of Puberty (5th grade) / Sexual Health (secondary)?

This field is required

Parent/Guardian Full Name

This field is required

Parent/Guardian Email

This field is required

Form automated with

HIV/AIDS Prevention & Sexual Health Opt-Out Request

Form Submitted