STUDENT HEALTH INFORMATION FORM - oceducation.org 2025

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  1. Click ‘Get Form’ to open it in the editor.
  2. Begin by entering the student's full name, age, and contact numbers in the designated fields. Ensure accuracy for effective communication.
  3. Fill in the birth date and emergency contact information. Specify a relationship to the student for clarity.
  4. Provide details about the student's physician and insurance carrier, including policy number for any medical needs.
  5. Indicate if all required immunizations are up to date, noting the last date given for Tetanus.
  6. Address any health conditions or allergies by providing detailed explanations where necessary, ensuring all relevant information is included.
  7. List any prescription medications along with their dosage and frequency. Ensure these are in original packaging as per guidelines.
  8. Review over-the-counter medication preferences and check 'YES' or 'NO' accordingly before finalizing your form.

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call the CDC Information Contact Center at 800-CDC- INFO (232-4636). Congratulations! Now you should take the records to your provider or local public health clinic and ask them to document this information on an official record, and, if possible, in the state or local immunization registry.
Preparing for College: Why Your Student Needs a Health Care Proxy and Durable Power of Attorney. Parents of college students or of any child who has turned 18 years old should encourage their adult child to execute a durable power of attorney, health care proxy and HIPAA Authorization.
Records you may need to bring include a government-issued photo ID, your bank information, health and immunization records, evidence of insurance, and other legal documents. The information contained in these items may be required for various aspects of college life, especially during the first few weeks.
The schools health services webpage may include links to free forms that your family can use. Your doctors office at home may also provide one. To be on the safe side, fill out HIPAA release forms for your home state and the school state.
Essential Legal Documents Every College Student Should Have Health Care Proxy (Medical Power of Attorney) HIPAA Authorization Form. Durable Power of Attorney. FERPA Waiver. Living Will (Advance Directive) Proof of Health Insurance.

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