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Click ‘Get Form’ to open it in the editor.
Begin by entering the Student ID # at the top of the form. This is essential for identification.
Fill in the student’s full name, grade for the 18-19 school year, and address including street, city, and zip code.
Provide emergency contact information, including name, relationship to the student, and phone numbers.
Complete the medical history section by answering each question with 'Yes' or 'No'. If you answer 'Yes', be prepared to explain in the designated box below.
For any questions regarding cardiovascular health issues, ensure that you understand their implications as they may require further medical evaluation.
Finally, both student and parent/guardian must sign and date the form at the bottom before submission.
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