Medical Form.pptx 2025

1. Click ‘Get Form’ to open the Medical Form.pptx in the editor.
2. Begin by entering the student’s name in the designated fields for Last, First, and Middle Initial.
3. Fill in the Date of Birth and select the appropriate sex (M or F) from the options provided.
4. Provide Parent or Guardian names, along with their home address, including street, city, state, and zip code.
5. Enter both home and cell phone numbers for easy contact.
6. If applicable, complete the Family Doctor’s Name and Office Phone Number sections.
7. Address medical history questions by indicating if your child is taking any prescription or over-the-counter drugs. List details as required.
8. Note any allergies or physical/mental conditions that should be communicated to program staff or Student Health Services.
9. Designate a contact person if the parent or guardian is unavailable, providing their name, relationship, address, and phone numbers.
10. Finally, authorize treatment by signing and dating at the bottom of the form.

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