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STUDENT HEALTH HISTORY FORM 15802 N Park view Pl Surprise, AZ 85347-7466 (623) 876-7000 www.dysart.org FOR OFFICE USE ONLY Print Form TEACHER GRADE STUDENT INFORMATION Legal Last Name Gender Legal

How to fill out student health history form

How to fill out a student health history form:

1. Start by carefully reading the instructions and requirements provided with the form.
2. Begin filling out the personal information section, which may include your full name, date of birth, contact information, and student identification number.
3. Provide details about your medical history, including any chronic illnesses, allergies, surgeries, medications, or mental health conditions you may have.
4. Answer questions about your family medical history, such as any genetic disorders or hereditary conditions that run in your family.
5. Indicate any specific health concerns or disabilities that may require special accommodations or support from the educational institution.
6. Provide emergency contact information, including the names, phone numbers, and relationships of individuals who should be notified in case of a medical emergency.
7. Sign and date the document to certify that the information provided is true and accurate.
8. Return the completed form to the designated office or person as instructed.

Who needs a student health history form:

1. Students enrolling in educational institutions, such as schools, colleges, or universities, are typically required to fill out a student health history form.
2. It helps educational institutions to have the necessary information about a student's medical background in order to provide appropriate support, accommodations, or medical care if needed.
3. The form is essential for the safety and wellbeing of the student, as it allows healthcare professionals on campus to be aware of any pre-existing conditions or potential health risks.
4. Parental or guardian consent may be required for students under a certain age, and their involvement in completing the form may be necessary.

Note: The specific requirements and process for filling out a student health history form may vary depending on the educational institution. It is always advisable to carefully follow the instructions provided with the form and seek guidance from relevant staff if necessary.

For pdfFiller’s FAQs

What is student health history form?

The student health history form is a document that collects information about a student's medical history, current health status, and any allergies or medications they may be taking.

Who is required to file student health history form?

All students, typically enrolled in educational institutions, are required to file a student health history form before the start of the academic year.

How to fill out student health history form?

To fill out a student health history form, students or their parents/guardians must provide accurate information about the student's medical history, current health status, allergies, and medications. The form is usually provided by the school or educational institution.

What is the purpose of student health history form?

The purpose of the student health history form is to ensure that educational institutions have vital medical information about students in case of emergencies, to provide appropriate medical care, and to identify any health concerns that may impact the student's academic performance.

What information must be reported on student health history form?

The student health history form typically asks for information about the student's medical conditions, allergies, medications, immunization history, recent illnesses, surgeries, and contact information for emergency purposes.

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