Health Services Forms
English
Health History Form/Historia de Salud ( Required for all new students or if there are any changes to your child's health status.)
Parent Authorization for Release of Health Information
Forms Required by CA State Law
Report of Health Examination for School Entry
Oral Health Assessment Form EN and SP
Oral Health Parent Waiver EN and SP
Oral Health Parent Notification Letter EN and SP
On-site Dental Screening Opt-out EN and SP
Forms for Medication at School
Medication Authorization Form (Required for all students who take any medication at school. A new form must be completed every year.)
Forms for Physicians
Physical Education Modification (Use this form if/when your student has health or physical limitations which may interfere with their participation in PE)
Request for Physician Information (Use this form if/when parents/guardians are asked for additional information from a physician regarding a student health issue or injury)
Allergy/Asthma Forms
Food Allergy Action Plan (FARE)
Bee and Insect Sting Questionnaire
Diabetes Forms
Diabetes Health Care Plan Request
Type 1 Diabetes Information Sheet
Seizure Forms