Medical File Update
for returning students only
Student Name
Parent Name
First Name
Last Name
Date
/
Month
/
Day
Year
Date
Preferred Email
example@example.com
I have reviewed the following forms and confirm by checking each box that no information has changed since these forms were originally submitted.
*
Children's Medical Report
Immunization Record
Additional Forms for students with medical conditions, disabilities, accessibility requirements, or other concerns: (check all that apply to confirm these forms are current and do not need to be updated):
Asthma Action Plan
Seizure Action Plan
Permission to Administer Medication
Student Accessibility Info Form (for children requiring accommodations or additional support to access their education)
Other
Signature
Continue
Continue
Should be Empty: