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Intake Form: Supporting Student Gender Identity

About this Form

Form number: 560-80

Audience:  MCPS Staff

Last revised: June 2019

Instructions: The school administrator, counselor, or psychologist should complete this form with the student. Parents/guardians may be involved if the student states that they are aware of and supportive of the student’s gender identity. This form should be kept in a secure, confidential location (e.g. the principal’s/counselor’s/psychologist’s files). This form is not to be kept in the student’s cumulative or confidential folders. All plans should be evaluated on an ongoing basis and revised as needed.

Adobe PDF Intake Form: Supporting Student Gender Identity806 KEnglish
Adobe PDF Formulario de Inscripción: Apoyo a la Identidad de Género de los Estudiantes416 KSpanish
Adobe PDF Formulaire d'admission : Soutien à l'identité de genre des élèves415 KFrench
Adobe PDF MẫuThâu Nhận: Hỗ Trợ Nhận Dạng Giới Tính của Học Sinh482 KVietnamese
Adobe PDF 登記表: 支持學生的性別認同558 KChinese
Adobe PDF 접수 양식: 학생 성 정체성 지원444 KKorean
Adobe PDF የተማሪ ጾታ መለያ መቀበያ ቅጽ፦445 KAmharic

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