Health Forms

It is our responsibility to help meet the medical needs of your child when he/she is in school.

We have various forms that will be required for certain situations.

Mandatory Forms for ALL STUDENTS:

School Health Record: to be completed by your pediatrician.

Vision Form: to be completed by your pediatrician.

6th-8th Grade Sports Team Forms:

PLAYERS CANNOT TRY OUT FOR A TEAM WITHOUT THESE FORMS ON FILE.

• Athletic Physicals Form: To be filled out by patient and parent prior to seeing the physician, and brought to the physician.

• Health History Update

• Sports Injury Form

For Special Health Needs:

• Asthma Form: Required for all asthmatic students; to be completed by the parent and physician.

• Allergy Form: Required for all students with allergies requiring an Epi-pen or Benadryl. To be
completed by the parent and physician.

If your child is allergic to antibiotics, you can just note it on the health record.

• Consent for Delegate Administration of Epinephrine: For all students requiring an Epi-pen.

• Self-Administration Form: For students requiring medication on school trips (excluding Epi-pens);
to be completed by the parent and physician.

• Medication Administration Form: For special health care needs not addressed

 

Please note, at all times, medication whether prescription or OTC (over the counter) requires a physician’s order.