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Health Department: School Health Forms

Inhaler/Asthma Action Plan

September 26, 2006

The link below is a Word document for parents to fill in and print off.  It is a management plan to be used for a child with asthma or anaphylaxis medical conditions.  Contact Nurse Dean if you have any questions on filling . . . read more

Activities Participation Form

by Taryn Retzlaff | September 6, 2005

Activities Particpation Form This form is only required for those students that have not submitted a physical, but are participating in other activities that may involve out-of-town excursions.  Its purpose is to provide . . . read more

Documentation of Varicella Form

Has your child had Chickenpox?

by Taryn Retzlaff | September 6, 2005

Documentation of Varicella Form read more

Inhaler Contract Form

by Tammy Dean | September 6, 2005

Inhaler Contract Form Bridgeport Public Schools medication guidelines permits a responsible, trained student to carry and/or self-administer medication for asthma (wheezing) or diabetes on his/her person for immediate use with . . . read more

Medical Authorization Form

by Tammy Dean | September 6, 2005

Medical Authorization Form THIS IS A REQUEST TO PROVIDE MEDICATION DURING SCHOOL HOURS read more

Medical History Form

by Tammy Dean | September 6, 2005

Medical History Form This form is in regards to your child's medical history. read more

Permission for Release and Exchange of Information Form

by Tammy Dean | September 6, 2005

Permission for Release & Exchange of Information Form read more

Physical Examination Requirements Form

by Tammy Dean | September 6, 2005

Physical Examination Requirements Form The Board of Education shall require evidence of a physical examination by a physician, physician assistant, or nurse practitioner within six months prior to entrance of a child into the . . . read more

Refusal of Immunization for Religious Reasons Form

by Tammy Dean | September 6, 2005

Refusal of Immunization for Religious Reasons Form read more

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