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Health Forms

2019-20 Health Forms

Listed below in PDF format are 2019-2020 forms from MPH’s Health Office. Please contact the Health Office at 446-2452, ext. 127 with any questions. Forms may be faxed to the Health office at 1-866-846-0684.

The Medication Permission Form and Health Appraisal Form are required for all students, both new and returning. Consult with your physician to make sure all immunizations are up to date.  Physicals are required for Kindergarten and odd years and should be less than a year old at the start of school. You may consider having field trip forms signed by your physician at the same time your other documents are signed for convenience.

Immunization Requirements

Medication Permission Form 2019-2020 (must be signed by physician)

NYS Screening Requirements

NYS School Health Exam Form

Reminder for Parents of Rising 6th, 7th, and 12th Grade Students

Administration of Medication Authorization On Field Trips (must be signed by physician)

Information Regarding Medication on Field Trips

Emergency Care Plans

Asthma Emergency Care Plan

Food Allergy Emergency Care Plan

MPH Concussion Protocol 2019

CDC concussion tool