• Health Information Forms


     
    Health Information Forms are required to be filled out on each student every year. The information you provide helps us care for your child should they come to the health room or in the event of an emergency. Your child's health information is confidential and may only be shared with other members of the educational team on a need to know basis. 
     

    Completing the Health Information Form


    Insurance. Please indicate if you have insurance (please include the name of your insurer, example: BCBS or MOHealthNet), or no insurance for your child. The information is used in aggregate form as statistical data to the state for assistance with funding for family programs.

    Allergies. It is imperative to identify your child's allergies - food, medication, environmental, etc. If your child has a serious allergy, please speak directly to the health room staff so we can make accommodations for your student. 

    Asthma. If your child has a diagnosis of asthma, please complete the back of the Health Information Form as completely as possible. The information you provide helps the health room staff care for your child.

    Medications. Please list any medications your child is currently taking or takes on an as needed basis. 

     

     

    Health Information Form 2018-19