Health Forms & Action Plans

Health Forms

Student Health History
Immunization Forms
Religious Exemption Form

Action Plans

Allergy Action Plan
Emergency/Epinephrine Allergy Form
Diabetes Management Plan
Sickle Cell
Loeys-Dietz Syndrome
Wolff Parkinson White Syndrome


Physical Forms

* Required for PreK, Kindergarten, Sixth and Ninth Grade students, as well as any student entering from out-of-state.


Vision Forms

Regulations require eye examinations of all children enrolling in kindergarten in a public, private or parochial school and any student enrolling for the first time in a public, private or parochial school.  The examination must be performed by a physician licensed to practice medicine in all its branches or a licensed optometrist within the previous year.  Proof of the examination must be provided to the school by October 15th.

Eye Examination Form

Dental Forms

* Required for Kindergarten, Second and Sixth Grade students


Illness Guidelines from Handbook


Medication Administration Forms

Medication Administration Form