Chronic illness verification form 2025

1. Click ‘Get Form’ to open the chronic illness verification form in the editor.
2. Begin by entering the student's name, date of birth, grade, and school name in the designated fields. Ensure all information is accurate for proper record-keeping.
3. Instruct your physician to list the diagnosed chronic illness and check any relevant symptoms that may require the student to stay home from school. This section is crucial for understanding the child's needs.
4. The physician must provide their signature and date in the specified area. An attached business card or letterhead is required for validation.
5. Fill out the expected frequency of episodes and length of absence per episode. This helps the school anticipate and manage attendance effectively.
6. Complete any additional comments or notes that may assist in clarifying the student's condition or needs.
7. Finally, ensure that a parent/guardian signature is obtained along with the date to authorize information exchange between health services and school staff.

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