Health Office Forms

Required NY State

Physical Exam Form

*Needs Healthcare Provider Signature

Permission to Administer Over the Counter Medications

*Needs Healthcare Provider Signature

Permission to Administer OTHER MEDICATIONS

*Needs Healthcare Provider Signature

Allergy Forms

If your child has an allergy that needs special care, please fill out a GENERAL ALLERGY CARE PLAN.

For those children at risk for ANAPHYLAXIS, please fill out the FARE EMERGENCY CARE PLAN and have it signed by your healthcare provider.

Si su hijo tiene una alergia que necesita atención especial, complete un PLAN GENERAL DE CUIDADO DE ALERGIAS.

Para aquellos niños en riesgo de ANAFILAXIS, complete el PLAN DE CUIDADO DE EMERGENCIA FARE y haga que lo firme su proveedor de atención médica.

ASthma Forms

If your child has asthma, please fill out the GENERAL ASTHMA form.

If your child needs an inhaler at school, please fill out the PERMISSION TO ADMINISTER OTHER MEDICATIONS above.

Si su hijo tiene asma, complete el formulario GENERAL ASTHMA.

Si su hijo necesita un inhalador en la escuela, complete el PERMISO PARA ADMINISTRAR OTROS MEDICAMENTOS anteriores.