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. Release of Information (ROI) Authorization
3. Self-Administration of Medication Authorization (completed by Health Care Provider)
4. Overnight Field Trip Authorization

Specifically for students with Anaphylaxis, Asthma, Diabetes, and/or Seizures

1. Authorization for the Administration of Medication/Treatment
2. Self-Carry, Self-Administer Medication Agreement
3. Anaphylaxis Action Plan
4. Allergic Reaction Questionnaire
5. Asthma Action Plan
6. Asthma/Breathing Questionnaire
7. Diabetes Questionnaire
8. Diabetes [Medical] Management Plan for School (DMP)
9. Seizure Action Plan
10. Seizure Questionnaire

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