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RYE CITY SCHOOL DISTRICT HEALTH CARE SERVICES Middle School 3 Parsons Street Rye, New York 10580 (914) 9676100 Ext. 2930 Fax: (914) 9216189 High School 1 Parsons Street Rye, New York 10580 (914) 9676100
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How to fill out the student health restriction/injury form:

01
Start by carefully reading the instructions on the form. Make sure you understand the purpose and requirements of the form.
02
Provide your personal information such as your full name, student ID number, contact details, and date of birth. This is important for identification purposes.
03
Indicate the specific health restrictions or injuries that you have. If you have multiple restrictions or injuries, provide details for each one separately.
04
Clearly explain the nature of your health restriction or injury. Include information such as the date it occurred, any medical treatments you have received, and any ongoing symptoms or limitations.
05
Attach any supporting documentation that may be required, such as medical reports or notes from healthcare professionals.
06
If applicable, provide information regarding any accommodations or special assistance you may need. This could include adjustments in class schedules, modified physical activities, or transportation needs.
07
Sign and date the form to indicate that the information provided is accurate and complete.
08
Submit the form to the appropriate department or person as instructed. Be sure to keep a copy for your records.

Who needs the student health restriction/injury form?

01
Students who have a temporary or permanent health restriction or injury that may impact their academic activities or require accommodations.
02
Student-athletes who have suffered an injury or have ongoing health restrictions affecting their participation in sports.
03
Students who require special assistance or accommodations due to a health condition or injury.
Note: The specific individuals or departments that require this form may vary depending on the educational institution or organization. It is essential to consult the guidelines or contact the relevant authority for accurate information.
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The student health restriction/injury form is a document used to report any health restrictions or injuries that may impact a student's ability to participate in school activities.
The student or their parent/guardian is required to file the student health restriction/injury form.
To fill out the student health restriction/injury form, the student or their parent/guardian should provide details about the health restriction or injury, including its impact on the student's activities.
The purpose of the student health restriction/injury form is to ensure that the school is aware of any health restrictions or injuries that may impact a student's participation in school activities, and to make accommodations if necessary.
The student or their parent/guardian must report details about the health restriction or injury, including its impact on the student's activities and any accommodations that may be needed.
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