Forms & Health Information for Download

All documents below are produced in Microsoft Word format unless otherwise stated. If you need assistance or need the form in another format, please contact your school nurse.

I. Forms

Request for Assistance with Dental Services Form

Authorization for the Administration of Medicine by School Personnel Form

State of Connecticut Department of Education - Health Assessment Record (The Blue Form) for students K-12

State of Connecticut Early Childhood Health Assessment Record (The Yellow Form) for students Pre-K

DHS Athletic Emergency Form

Out of Town Form

Physical Activity Start Restriction - End Restriction Form / Return to Physical Activities Form

Sports Participation Health Record (The White Form) NOTE: To be completed by both parent & doctor

Student Emergency Card

Pre-Kindergarten Health and Development History

II. Information

Health Services Contact Information & Local Doctor List 2008