270 East State Street
Columbus, OH 43215
spirit of success

Student Health Forms

Student Health Forms
Health Services Consent Form
Information and Consent regarding your child's health and our ability to serve them
Student Health Questionnaire
Basic health information about your student
Medication Authorization
For students who must have access to medication at school
Allergy Packet
For students with allergies that could need treatment at school
Asthma Packet
For students with asthma
Seizure Packet
For students who have had seizures
Dental Record
For preschool enrollment, or to provide nurse information from dentist
Diabetes Questionnaire
Explain to the nurse how diabetes affects your student
Diabetes Medical Management Plan
Explain the details of your student's diabetes care--requires doctor signature
Medical Record
For preschool enrollment, or to report the result of a check-up to the school nurse--requires doctor signature
Specialized Health Care Services Request
For when a student must have medical procedures performed at school--requires doctor signature
Student Health Questionnaire in French
étudiant questionnaire de santé en français pour l'inscription
Student Health Questionnaire in Somali
questionnaire caafimaadka ardayga ee somali ah ee is-qoritaan
Student Health Questionnaire in Spanish
estudiante cuestionario de salud en español para la inscripción
Spanish footer button       French footer button       Somali footer button       Nepali footer button       Arabic footer button
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Our Mission: Each student is highly educated, prepared for leadership and service, and empowered for success as a citizen in a global community.
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