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DELAWARE STUDENT HEALTH FORM ADOLESCENT Grades 7-12 To be completed by licensed healthcare provider: Physician (MD or DO), Clinical Nurse Specialist (APN), Advanced Practice Nurse (APN), or Physician
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How to fill out the student health form:

01
Begin by carefully reading through the instructions provided with the form. It is important to understand what information is required and how it should be filled out.
02
Start with the personal information section. Fill in your full name, date of birth, and contact details accurately.
03
Move on to the medical history section. Provide information about any pre-existing medical conditions, allergies, medications you are currently taking, and any other relevant health information.
04
If required, fill out the immunization section. This typically includes details about your vaccination history, including dates and types of vaccines received. If you are unsure about your immunization records, consult with your healthcare provider.
05
Complete the emergency contact information section. Provide the names and contact details of individuals who should be notified in case of an emergency.
06
Review the completed form for accuracy and make any necessary corrections. Double-check that all required fields have been filled out.
07
Sign and date the form in the designated areas. This indicates that the information provided is true and accurate to the best of your knowledge.
08
Submit the completed form to the appropriate person or organization as instructed. This is typically the school or college administration or the healthcare provider responsible for maintaining student records.

Who needs the student health form?

01
The student health form is required for students enrolling in educational institutions such as schools, colleges, and universities.
02
It is necessary for both new students and returning students, as it helps in ensuring the overall health and well-being of the student population on campus.
03
The form is essential for providing relevant health information to healthcare providers, school nurses, and administrators, who may need it to provide appropriate care or support in case of emergencies or ongoing medical needs.
04
Additionally, the student health form may also be required for participating in sports or other physical activities to ensure the safety and preparedness of the students.
05
It is important to follow the specific guidelines and deadlines provided by the educational institution to ensure timely submission of the form.
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The student health form is a document used to gather health information about students in educational institutions.
All students enrolled in educational institutions are required to file the student health form.
To fill out the student health form, students must provide accurate and up-to-date information about their health history, current medications, allergies, and any existing medical conditions.
The purpose of the student health form is to ensure that educational institutions have accurate health information about their students in case of emergencies and to provide appropriate medical care.
Students must report health history, current medications, allergies, existing medical conditions, emergency contacts, and any other relevant health information on the student health form.
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