Staff health history form - Knowlton Township Elementary School 2026

1. Click ‘Get Form’ to open the Staff health history form in the editor.
2. Begin by entering your personal information, including your name, birthdate, and social security number. Ensure accuracy as this information is crucial for emergency situations.
3. Fill in your contact details, such as phone number and address. This section also requires the name and phone number of your family physician and an emergency contact person.
4. Indicate your blood type and provide details about your last tetanus booster and Hepatitis B vaccine. This information is vital for medical personnel.
5. Complete the health history section by answering questions regarding allergies, chronic conditions (like asthma or diabetes), and any medications you are currently taking.
6. Finally, review all entries for accuracy before signing the form. You can initial if you agree that the school nurse may have a copy of this form.

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