Health Room Appointment Request - Solanco HS
If you are experiencing a medical emergency, have your teacher call the health room for help right away.
Name
*
First Name
Last Name
Email
*
example@example.com
Current Location (Teacher and Room Number)
*
What symptoms are you having?
Do you know you have any medical conditions that might be causing your symptoms? Allergies for example?
Has anything happened to you in the past two days that might have caused your symptoms?
Have you recently been around someone else with similar symptoms?
Yes
No
Unsure
Please describe any other concerns you may have.
Submit
Should be Empty: