FORMS
**These forms are required for entry**
Preschool Form Requirements: Physical, Vision
Kindergarten Form Requirements: Physical, Dental, Vision
6th Grade Form Requirements: Physical
Below you may access all forms that may be needed for your student while at school. Please click on the form you need.
Allergy Care Plan- needed for students with severe allergies that require rescue medication at school
Asthma Care Plan- needed for students with asthma that take rescue medication at school
Consent for Care- required for all students, includes health conditions and permission for the nurse to see the student if needed
Dental Exam Form- to be completed if the student has a dental check-up. Required for entry into Preschool and Kindergarten.
Extended Day/Overnight Field Trip Medication Form- to be completed if the student will be going on a field trip that extends past normal school hours or is overnight. ALL medications require a guardian and physician signature, including over-the-counter medications.
Grades 5-8 Sports Physical- to be completed if the student will be participating in a sport. Forms can be turned in to Scott Noel at SCMS.
Grades 9-12 Sports Physical- to be completed if the student will be participating in a sport. Forms can be turned in to John Howie or Jacob Snider.
Individual Health Care Plan- needed if the student has a condition that requires treatment or special care (ex.: catheterization, bleeding disorders, etc.)
Individual Health Care Plan: G-tube Feeding- needed if the student has a condition that requires a g-tube feeding or flush while at school.
Individual Health Care Plan: Urinary Catheterization- needed if the student has a condition that
requires urinary catheterization while at school.
Eating and Feeding Evaluation Plan: to be used for student with special needs regarding feedings, and specialized meals
KY Immunization Certificate- blank immunization certificate, students are required to remain complaint
Medication Authorization- needed if the student will need ANY medication at school. Prescribed medication must have a guardian AND physician signature. Over-the-counter medications must have a guardian signature.
Physical Form- to be completed if the student has a physical exam. Required for entry into Preschool, Kindergarten, and 6th grade.
Religious Declination of Immunizations- to be completed if the parent/guardian choses for their student to not receive all required immunizations. Must be completed and signed in front of a notary
Seizure Care Plan- to be completed by ALL students with a history of seizures, regardless of medication use
Vision Exam- to be completed by an optometrist or ophthalmologist if the student receives an eye exam. Required for entry into Preschool and Kindergarten.