Health Services Forms
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Guidelines for Parents on Keeping Ill Students Home
Guidelines for Parents on Keeping an ill Student Home 2023.pdf 275.79 KB (Last Modified on April 26, 2023) -
Student Medical Health History Record Form - Confidential - English
Completed during registration.
Student Health Questionnaire - Confidential 2022-2023 filable form.pdf 198.37 KB (Last Modified on July 28, 2022) -
Student Medical Health History Record Form - Confidential - Spanish
Completed during registration
Student Health Questionnaire - Confidential 2022-2023 SP fillable.pdf 195.78 KB (Last Modified on July 28, 2022)
Athletic Sports Teams
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Athletic Sports Physical & Consent and Liability Release Form - English
Parent and student signature required
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Athletic Sports Physical & Consent and Liability Release Form - Spanish
Se requieren firmas de padres y estudiantes
Health Exams, Immunizations, & Oral Assessments
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Guide to Immunizations Requirement for TK/K-12 - English
IMM-231 CA Immunization Requirement for K-12 rev 1-2021.pdf 60.59 KB (Last Modified on January 15, 2021) -
Guide to Immunizations Requirement for TK/K-12 - Spanish
IMM-231S CA Immunization Requirement for K-12 rev 1-2021.pdf 60.76 KB (Last Modified on January 15, 2021) -
Medical Exemption from Immunizations Information Notification
This is an information letter regarding how to obtain a Medical Exemption from CAIR-ME for required immunizations for school entry.
5141.31 E-6 w-sp Medical Exemption Requirements for Immunizations - New law 1-2023.pdf 594.06 KB (Last Modified on January 11, 2023) -
Report of Health Examination for School Entry - CHDP -1st Grade Requirement
Report of Health Examination for School Entry pm171a 2007.pdf 162.73 KB (Last Modified on November 6, 2018)
Medication, Asthma Care Plans, Diabetic Management Plan & Anaphylaxis Treatment Plans
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Diabetes Medical Management Plan
Required form for a Student with Diabetes
DMMP - Diabetic Medical Management Plan 2021-22 Fillable.pdf 530.73 KB (Last Modified on February 8, 2022) -
Food Allergy and Anaphylaxis Emergency Care Plan
Required form if a student has an Epipen or Auvi-Q at school
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Medication Guidelines and Procedures Parent Information
This is guidelines and procedures for medication taken during school hours.
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School Sponsored Trips and Off-Site Activities Release for Students with Diabetes
Required form for students with diabetes that participate in school sports activities and/or school field trips.
Diabetes Trip-Activity Release w-sp 2019 fillable form.pdf 127.63 KB (Last Modified on August 27, 2020) -
Student Agreement Asthma Mangement in School
Required if student will be carrying inhaler
5141.23 E-2 Student Agreement Asthma Management 1-2018 w-SP.pdf 215.44 KB (Last Modified on November 6, 2018)