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HEALTH MANAGEMENT PLAN VENTRICULOPERITONEAL SHUNT (VP SHUNT) SCHOOL YEAR: STUDENT NAME: SCHOOL: DOB: STUDENT ID: CONTACTS: MOTHER: HOME: WORK: CELL: If parents cannot be reached contact: Name: Name:
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01
Start by downloading the school clinic copy form from the official school website.
02
Fill in your personal information such as your name, address, and contact number.
03
Provide details about your medical history, allergies, and any current medical conditions.
04
Indicate any medications you are currently taking and dosage instructions.
05
Specify any emergency contacts who should be notified in case of a medical situation.
06
Sign and date the form to verify its accuracy and completeness.
07
Submit the filled-out school clinic copy form to the school clinic staff.

Who needs school clinic copy of?

01
Students who have ongoing medical conditions or allergies.
02
Students who require regular medication or have specific medical needs.
03
Students who may be at risk of experiencing a medical emergency while at school.
04
Parents or guardians who want the school to have up-to-date medical information about their child.
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The school clinic copy of is a duplicate form that contains health records and information of students.
School nurses or health professionals are required to file the school clinic copy of.
The school clinic copy of can be filled out by entering student's health information, medical history, and any medications or treatments.
The purpose of school clinic copy of is to maintain accurate health records of students and ensure appropriate medical care is provided if needed.
Information such as student's name, date of birth, medical conditions, allergies, medications, emergency contacts, and any medical treatments or procedures should be reported on the school clinic copy of.
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