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Forms
Back to School Help Fair Flyer:
Back To School Fair Flyer 2023
Physical Form:
Child Health Exam Form Revised 01 31 2024 (1)
Child Health Exam With Parent Section
Forms Owh Child Health Exam Spanish 042916
SPORTS PHYSICAL FORM (This can’t be used for the school physical)
Dental Forms:
Dental Exam Form 2021 Editsspanish Final
Dental Exam Waiver 2021 Editsspanish Final
Kindergarten Round up forms (Click on link)
Meningococcal Form:
Wellness Express Forms:
SIU Consent Required For All Physicals
Directions For Filling Out IDPH Forms For Wellness Express
Allergy Policy and Forms:
Guideline For Management Of Children With Life Threatening Allergies Revised 2019
Allergy Medical Management Plan (Action plan plus orders)
Physician Statement For Food Substitution
Girls Talk Outline:
Asthma Forms:
Asthma Medical Management Plan (Action plan and orders)
Parental Authorization Request For Self Administration Of Asthma Inhaler
Seizure Forms:
Seizure Medical Management Plan (Action plan and orders.)
Diabetes:
DIABETES MEDICAL MANAGEMENT PLAN
QPS Dexcom Authorization Letter
Medication Forms:
AUTHORIZATION AND PERMISSION FOR ADMINISTRATION OF MEDICATION
AUTHORIZATION AND PERMISSION FOR SPECIALIZED MEDICAL TREATMENT
(For Seizure, asthma, diabetes, and allergy orders, please refer to those sections located above.)
Diabetes:
DIABETES MEDICAL MANAGEMENT PLAN
QPS Dexcom Authorization Letter
Eye Exam Forms:
Other Forms:
Facts about Meningococcal Disease