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School personnel health record

School personnel health record 2025

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4.4 out of 5

58 votes

The document is a health record form for school personnel in Pennsylvania, detailing patient information, immunization history, tuberculosis test results, significant medical conditions, and a report of physical examination. It requires personal details, vaccination records, and medical evaluations to ensure the health and safety of school employees.

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Click ‘Get Form’ to open the school personnel health record in the editor.
Begin by filling out the Patient Information section. Enter the last name, first name, middle initial, social security number, sex, date of birth, and contact numbers. Ensure all details are accurate for proper identification.
Proceed to the Immunization History section. Record each immunization date along with doses and boosters for vaccines like Diphtheria and Tetanus, Hepatitis B, and Measles, Mumps, Rubella. This information is crucial for compliance with health regulations.
In the Required Tuberculosis Test Results section, input relevant dates and results from tests conducted. Attach any necessary reports as indicated.
Complete the Significant Medical Conditions section by marking 'Yes' or 'No' for various conditions. If applicable, provide detailed explanations in the space provided.
Fill out the Report of Physical Examination section by indicating normal or abnormal findings for each listed item. Include comments where necessary.
Finally, ensure that both the physician and employee sign and date the form to validate its authenticity before submission.

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See more school personnel health record versions

We've got more versions of the school personnel health record form. Select the right school personnel health record version from the list and start editing it straight away!

Versions	Form popularity	Fillable & printable
2011	4.9 Satisfied (45 Votes)
2000	4.4 Satisfied (58 Votes)

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What is the best way to send my school personnel health record for eSignature?

Upload your school personnel health record to DocHub (after you’ve created an account for this). If you need to fill out fields in it, use proper tools from the upper pane. For instance, drop Signature Fields, assign each to specific person, and click on Sign → Request signatures from others. Customize your message for your recipients and click Send Request. You can also send your paperwork by fax or as a Signing link instead of using email (you’ll locate these options by navigating to the Menu → Send)

How do you create an e-signature for the school personnel health record on iOS?

Apart from a comprehensive toolset for editing PDFs on mobile phones, DocHub enables you to sign your school personnel health record along the way. Open our editor in your internet browser, make changes using DocHub’s toolset, and finish your editing by eSigning the completed form.