2025 Student Medical Form

1

Please answer the questions to the best of knowledge. All answers are confidential and will only be read under emergencies or by the staff for the observation purposes only. The answers will not be discussed or revealed outside of Alkawthar School unless requested/directed to do so by medical personnel purpose.

2

Student Full Details* This field is required.

3

Check the conditions that apply to you or to any members of your immediate relatives:* This field is required.

Asthma

Diabetes

Hypertension

Autism

ADHD

Other

4

Do you have allergies?* This field is required.

Yes

No

Not Sure

5

Are you currently taking any medication?* This field is required.

Yes

No

6

If so, please list:

7

AUTORISATION

I Authorise staff in the Alkawthar School who are trained in the basics of first aid/CPR to give my child first aid/CPR when appropriate. I understand that every effort will be made to contact me in the event of an emergency requiring medical attention for my child. However, if I cannot be reached, I hereby authorise the Alkawthar School to transport my child to the nearest medical care facility and/or to emergency hospital near me, and to secure necessary medical treatment for my child.

By signing below, I agree that my past medical history statements indicated on this form is completely factual. I release Alkawthar School from any medical liability and costs. I agree to accept full financial responsibility for the costs related to this emergency treatment and give full confirmation by signing this document.

8

Terms and Conditions* This field is required.

9

Parent Signature* This field is required.

Clear

10

Today's Date* This field is required.