I hereby authorize Georgia College Student Disability Resource Center located at 231 West Hancock Street/Campus Box 123 in Milledgeville, GA 31061 to:
Release the following information: psychological, neuropsychological, and other evaluations and medical documentation needed for consideration of the extension of academic accommodations to:
Regents Center for Learning Disorders
University of Georgia
331 Milledge Hall
Athens, GA 30602