Downloadable Health Forms for Families

Health/Physical Exams:

  1. Preschool - 5th Grade (also used for ECS; completed by Health Care Provider)
  2. 6th - 12th Grade (also used for sports physical; completed by Health Care Provider)

Immunizations:

  1. Kindergarten - 12th Grade Immunization Record
  2. Child Care & Pre-Kindergarten Immunization Record

Authorizations/Releases/Consent forms:

  1. Authorization for the Administration of Medication/Treatment
  2. Authorization for the Administration of Medication/Treatment (specifically for students with Anaphylaxis, Asthma, Diabetes, and/or Seizures) 
  3. Release of Information (ROI) Authorization
  4. Self-Administration of Medication Authorization (completed by Health Care Provider)
  5. Self-Carry/Self-Administration of Medication Authorization (specifically for students with Anaphylaxis, Asthma, Diabetes, and/or Seizures)
  6. Asthma Action Plan (AAP)
  7. Overnight Field Trip Authorization

ECS (Early Childhood Screening) - Please print, complete, and bring each of these forms to your ECS appointment:

  1. Health History and Information
  2. Registration for ECS
  3. Parent-Guardian Consent (Rev. 11-30-12)

 

Completed forms can be emailed to:student.wellness@spps.org

SPECIAL DIET STATEMENT

CLOSE