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Health Forms

Here are some quick links to forms referenced throughout the Health Services website.

Absence From School Note (for 5 days or less)

Allergy and Anaphylaxis Emergency Care Plan

COVID-19 Athletic Release Form

Dental Health Form

Dental Health Form - Spanish

Health History

Health History - Spanish

Health History Update for Elementary Students

Immunization Medical Exemption Form

Interval Health History

Interval Health History - Spanish

Medication Order Form

Medication Order Form - Spanish

Authorization of Another Adult to Administer Medication

Authorization of Another Adult to Administer Medication - Spanish

Physical Exam Form

Working Paper Application

Working Paper Physical Fitness Certification

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Dominic Murray Clearance Form

Dominic Murray Clearance Form.pdf 40.01 KB (Last Modified on November 10, 2022)

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Parent Guardian Letter from School Health Services

Parent Guardian Letter from School Health Services.pdf 55.23 KB (Last Modified on November 10, 2022)

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Covid-19 Athletic Release 0321

Website -Athletic COVID-19 Release 0321.pdf 146.55 KB (Last Modified on March 15, 2021)

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Health History Update for Elementary Students

Website - Health History Update for Elementary 0518.pdf 362.32 KB (Last Modified on May 31, 2018)

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KCSD Health History

Website - Health History.pdf 132.59 KB (Last Modified on June 8, 2021)

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Health History - Spanish

website - Health History - Spanish.pdf 379.64 KB (Last Modified on January 22, 2018)

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