Health Forms

Sports Physicals

  • Sports Physical Form
    Sports Physical Form- Spanish

    The student’s doctor fills out this form on a yearly basis for students participating in district offered sports. It is submitted in the school front office for the site athletic director. The form must be submitted before a student can try-out for or practice any sport. It must be signed by a California licensed medical doctor or nurse practitioner.


Food Allergies

  • Food Allergy Notification Form

    This is a Food Service form documenting food allergies or sensitivities. It is only needed if the student will be eating the hot lunch offered by the district. The student’s doctor fills out this form on a yearly basis and it is submitted in the District Office for Food Service.

    Food Allergy Action Plan
    Food Allergy Action Plan- Spanish

    The student’s doctor fills out this form on a yearly basis if the student needs Epinephrine at school in case of an anaphylactic reaction to food. Parents also sign the form. Submit in the school front office for the site school nurse.


General Health

  • Student Health History Form
    Student Health History Form- Spanish

    Parents/guardians fill out this form for students new to the district (all grades) and incoming TK and Kindergarten students. Please submit with proof of immunizations when registering student at the school front office or the Kindergarten registration fair in February. Submit only once unless the student has a significant change in health.


Medications

  • Medication Permission Form
    Medication Permission Form- Spanish 

    The student’s doctor fills out this form on a yearly basis if the student needs medication (prescription and/or over-the-counter) during school hours. Parents/guardians also sign the form. Submit the form together with the medication (in its original container, with a pharmacy label if prescription) in the school front office for the site school nurse.

    Self-administered Medication Contract Form
    Self-administered Medication Contract Form- Spanish

    The student’s doctor fills out this form on a yearly basis if the student needs to carry on his/her person an emergency medication (ie inhaler, epinephrine) during school hours. Parents/guardians and students also sign the form. Submit in the school front office for the site school nurse.

stethoscope and apple
  • clipboard and checklist