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FOR SCHOOL USE:Room #: SCHOOLED SUPPLEMENTAL HEALTH SERVICES CONSENT FORM 20182019 Columbus City Schools (CCS) partners with Columbus Public Health (CPH) to offer Schooled Supplemental Health Services.
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How to fill out school-based supplemental health services

01
Obtain the necessary forms and documents from your school or school district for school-based supplemental health services.
02
Fill out personal information accurately, including name, date of birth, and contact details.
03
Provide information about the student's medical history, including any chronic conditions or previous surgeries.
04
Include any current medications that the student is taking and dosage instructions.
05
Specify the type of health service needed, such as physical therapy, speech therapy, or nursing care.
06
Provide any additional information or special instructions related to the student's health needs.
07
Review the completed form for accuracy and completeness.
08
Submit the filled-out form to the designated authority or school office for processing.

Who needs school-based supplemental health services?

01
School-based supplemental health services are available for students who require additional medical support while attending school.
02
This may include students with chronic health conditions, physical disabilities, developmental delays, or speech and language disorders.
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Students who need regular medical treatments, therapeutic interventions, or ongoing monitoring may benefit from these services.
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The eligibility for school-based supplemental health services is determined by the student's specific health needs and the policies of the school or school district.
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School-based supplemental health services refer to additional health services provided in schools to support student health and well-being, which may include mental health services, physical health screenings, and personalized health care plans.
Schools and educational institutions that utilize supplemental health services are required to file school-based supplemental health services documentation to ensure compliance with health regulations and funding requirements.
To fill out school-based supplemental health services, schools must gather relevant health information, complete specific forms provided by local health authorities or educational agencies, and submit the forms by the designated deadline.
The purpose of school-based supplemental health services is to enhance the overall health and educational outcomes of students by providing accessible health care services within the school environment.
Information that must be reported includes the types of services provided, the number of students served, funding sources, health outcomes, and any partnerships with health organizations.
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