DE School Physical Examination Form 2005 free printable template

Examiner s Signature: Date: ... Phone Number: Address: DELAWARE SCHOOL PHYSICAL EXAMINATION FORM Page 2 of 2 Section B 5 — 6-2005. Title: 2007 App. Phys Exam ...

How to fill out delaware school physical form

How to fill out DE School Physical Examination Form

1. Obtain the DE School Physical Examination Form from the school or a medical provider.
2. Fill in the student's personal information, including name, date of birth, and grade.
3. Complete the medical history section, including any pre-existing conditions, allergies, or medications.
4. Provide information about the child's immunization status as required.
5. Schedule a physical examination with a licensed healthcare provider.
6. Have the healthcare provider fill out the physical examination section, noting any relevant findings or recommendations.
7. Ensure the healthcare provider signs and dates the form.
8. Submit the completed form to the appropriate school authorities before the deadline.

Who needs DE School Physical Examination Form?

1. Students enrolling in a public school in Delaware.
2. Students participating in sports or extracurricular activities.
3. Any student requiring a physical examination for health reasons.

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What is DE School Physical Examination Form?

The DE School Physical Examination Form is a document used to report the results of a physical examination for students attending school in Delaware to ensure they meet the health and safety standards set by the state.

Who is required to file DE School Physical Examination Form?

The DE School Physical Examination Form is required to be filed by parents or guardians of students enrolling in school for the first time in Delaware, as well as for students entering specific grades as mandated by state law.

How to fill out DE School Physical Examination Form?

To fill out the DE School Physical Examination Form, a licensed healthcare provider must complete the medical examination section, indicating the student's health status, immunization records, and any medical concerns. Parents or guardians must provide personal information about the student and sign the form.

What is the purpose of DE School Physical Examination Form?

The purpose of the DE School Physical Examination Form is to assess the health of students, identify any potential health issues prior to enrollment, and ensure students are up to date on required vaccinations, thereby promoting a safe and healthy school environment.

What information must be reported on DE School Physical Examination Form?

The DE School Physical Examination Form must report the student's personal information, medical history, results of the physical examination, immunization status, and any recommendations or restrictions regarding the student's participation in school activities.