Pm 171 b 2026

1. Click ‘Get Form’ to open the pm 171 b in the editor.
2. Begin by entering the child's last name, first name, and middle name in the designated fields.
3. Fill in the address section with the number, street, city, and ZIP code.
4. Specify the school your child will be attending and enter their date of birth in the format Month/Day/Year.
5. Indicate the teacher's name if applicable.
6. As a parent or guardian, read through the waiver information carefully. Then check one of the options regarding your child's health examination preference.
7. Provide a reason if you choose not to have your child receive a health examination.
8. Sign and date the form at the bottom before submitting it back to the school.

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