Student Placement
Medical Packet

Download, complete and submit the following Medical Packet when submitting a Request for Reassignment/Transfer Request for a Medical Reason.  

Medical Packet.pdf



Instructions for Medical Packet: 

The following steps are for a transfer/reassignment request for medical and/or health reasons of the student.

  1. 1)  Submit an online request for Reassignment/Transfer Application for a medical and/or health reason. You will need to have your student’s medical doctor complete the Medical and/or Health Request Packet.

  2. 2)  You may submit up to three additional pages of comments or information with your Medical and/or Health Request Packet. Information submitted over the three page limit will be retained in the Student Placement Office and not forwarded to the Medical Review Committee. The addi- tional pages should be sent to the Student Placement Office at the address below or sent by fax to 980-343-5661.

  3. 3)  Complete the Authorization for Medical Records and Reports (page 2 of the packet).Your student’s medical doctor needs to complete the Physician Statement (page 3 of the packet) and return both the Authorization page and Physician Statement page to the Student Placement Office at our address below or by fax to 980-343-5661.

  4. 4)  Your student’s entire packet will be sent to a committee of physicians who will review your request. This committee will make a recommendation to the school system based on the medical situation. This recommendation becomes part of the information used to either approve or deny your request to change your student’s school assignment.

Due to additional steps involved in this process, please allow up to 8 weeks for a notification letter from the Student Placement Office. 


Student Placement

Smith Family Center
1600 Tyvola Road
Charlotte, NC 28210



P.O. Box 30035
Charlotte, NC 28230-0035
Phone: 980-343-3000
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