Dear Parents,

To access the Online Student Health Forms for the new school year, please click on the link below. These confidential forms may be completed and sent electronically, or if you prefer, you may print them and fill them out by hand. Please take time to complete these forms and return them no later than August 1.

1) Emergency Medical Authorization Form

This form is used whenever a student has a health concern at school or travels off-campus. State law requires that each student have this form on file yearly. It is important that you include telephone numbers to contact you in an emergency. Also, please include names and telephone numbers of individual who can be contacted if you are unavailable. Consent for medical treatment covers only an emergency as determined by emergency medical services. It does not mean that you are consenting for routine care.

Failure to return this form would be viewed the same as refusal to consent for emergency treatment and your child will not be able to participate in any field trips or athletic activities.

2) Health History Form

This form should be completed for all new students. Returning students should use this form to report any change in medical condition or updated immunizations. Some students have special health needs that require accommodations in school or a plan in the event of an emergency. If your student has a known health condition, please contact the school nurse to discuss a plan in the case of an emergency. Medical information will be kept confidential at your request. As of the 2010 school year, all students entering Kindergarten are required to have a second dose of the Varicella (Chickenpox) vaccine, and a IPV (Polio) vaccine on or after the 4th birthday. Students entering the 7th grade are required to have a booster dose of Tdap (Tetanus, Diphtheria, and Pertussis) or Td (Tetanus and Diphtheria) prior to the beginning of school. Students will be excluded from school on the 15th day if immunization mandates are not met.

3) Authorization for Over-the-Counter Medications Form

Please complete this for any non-prescription medication to be administered at school. For all students, please consent for administration by the school nurse. For students entering grades 7-12, also consent for administration by the athletic trainer. Any other non-prescription medications not listed may be sent in to the school nurse in the original container with written instructions.

Prescription medications may also be administered on a daily or temporary basis at school. All prescription medications, including inhalers, must be accompanied by a signed authorization from the health care provider. Medications must be in the original container with a clearly marked label. Please contact the school nurse for the appropriate forms.

Screening for vision and hearing will be done for Pre-K, K, 1, 3, 5, 7, 9, and all new students as mandated by the state. If any problems are identified, parents will be notified. Students who wear corrective lenses should have them at school.

We ask you to please confirm that you are agreeing to conduct this exchange electronically.

I have read the above information regarding the submission of the required Online Student Health Forms, including Ohio immunization requirements for school.

I agree

Last modified: Tuesday, 29 July 2014, 10:07 AM