Sample Refusal (Opt Out) Letters. This page has links to opt out letters for the tests New York STATE gives to 3rd-8th graders every spring.A letter requesting to opt-out their student must be sent to the school nurse prior to the screening clinic. Attendance Decisions; Illness Guidelines. STUDENT OPT-OUT FORM. You can write your own letter or use our sample letter. Community members and prospective community members are encouraged to read this report for awareness of policies, procedures, crime information and resources. Download the application below, print and fill it out, then mail it to the Middlesex County Clerk's office. Student Forms ; Request to Opt Out of Directory Information. Enrollment Services ; Request to Review Education Records.