Health History YEARLY Update Form
Click on link below to DOWNLOAD FORM
This Health History form must be filled out by Parent/Guardian, only.
Your Healthcare Provider is NOT required to fill out this Health History form.
Filling out this Health History form helps the school nurse to understand your children, and to better meet their healthcare needs.
Health History form contains:
~Emergency contacts - please update phone numbers with the main office when you get a new number.
~Insurance information
~Medical updates
~Over-the-counter medication administration needs parent/guardian permission.
*Please check off that school nurse may administer the following for headaches, cramps & minor discomforts so we can keep your children as comfortable as possible while remaining in school.
√Tylenol/Acetaminophen
√Advil/Motrin/Ibuprofen
√Cough Drops
√Benadryl (emergency purposes, ONLY; not for routine allergies)
√Tums (HS students, ONLY)
The "Standing Order" written by the school doctor allows the school nurse to administer the above medications with the parent/guardian written permission. No calls will be made home to obtain parental permission to administer medication.
Health History form valid for one school year only; must be renewed YEARLY.
Updated 3/16/2020