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Position H511.340 (Rev. 4/00) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF HEALTH SCHOOL PERSONNEL HEALTH RECORD I. Patient Information Last Name First MI D.O.B. Sex Social Security Number Home Telephone
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How to fill out school health form

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How to fill out a school health form:

01
In the first section of the form, provide personal information such as your full name, date of birth, address, and contact details.
02
Next, you may be required to fill in information about your medical history, including any chronic illnesses, allergies, or previous surgeries.
03
The form may ask you to provide details of your immunization and vaccination history. Make sure to accurately list all the vaccinations you have received and their dates.
04
You may also need to provide information about any medications you are currently taking, including dosage and frequency.
05
If you have any specific health concerns or conditions, such as asthma or diabetes, make sure to mention them in the relevant section of the form.
06
In some cases, you may need to get certain sections of the form filled out and signed by your healthcare provider. This may include a physical examination or a doctor's confirmation of your medical history.
07
Finally, carefully review the completed form for any mistakes or missing information before submitting it to your school.

Who needs a school health form:

01
Students: All students, regardless of age or grade, may be required to fill out a school health form. This form helps schools and staff understand the health needs and conditions of their students.
02
Parents/guardians: In cases where the student is a minor, parents or guardians are usually responsible for filling out the school health form on behalf of the student.
03
School administrators and healthcare providers: School administrators, nurses, or other healthcare providers typically require the school health forms to effectively provide appropriate care and support to students.
Note: The specific requirements for school health forms may vary depending on the school district or institution. It is important to check with your school administration for any additional guidelines or forms that may be necessary.
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The school health form is a document that includes information about a student's medical history, current health status, and any medications they may be taking.
All students attending a school are typically required to have a school health form on file.
Parents or guardians of students usually fill out the school health form with the help of a healthcare provider.
The purpose of the school health form is to ensure that the school is aware of any medical conditions or needs a student may have in order to provide appropriate care and support.
The school health form may require information such as medical history, current medications, allergies, emergency contacts, and any necessary medical authorizations.
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