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CAMBRIDGE PUBLIC HEALTH DEPARTMENT School Health Program HEALTH HISTORY From This form should be filled out by the child s parent or legal guardian. Return the completed form to your child s school
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How to fill out school health history form

How to fill out a school health history form:
01
Obtain the form: Start by obtaining a copy of the school health history form. This may be provided by the school or available for download on their website.
02
Read the instructions: Before filling out the form, carefully read all the instructions provided. Pay attention to any specific requirements or guidelines mentioned.
03
Personal information: Begin by providing your personal information, such as your full name, date of birth, address, and contact details. Make sure to write legibly and accurately.
04
Medical history: Answer all the questions regarding your medical history. This may include disclosing any chronic conditions, allergies, medications you are currently taking, previous illnesses or surgeries, and any relevant family medical history.
05
Immunization records: Record your immunizations and provide the dates of each vaccination. Ensure that you have the necessary vaccinations required by the school or educational institution.
06
Emergency contacts: Include the names and contact information of individuals who should be contacted in case of an emergency. This is typically done in the designated section on the form.
07
Signature and date: Once you have completed all the necessary sections, sign and date the form. This serves as confirmation that the information provided is accurate to the best of your knowledge.
Who needs a school health history form?
01
Students: All students, regardless of their grade level, may need to fill out a school health history form. This is typically required at the beginning of each school year or when enrolling in a new school.
02
Parents or guardians: Parents or guardians are responsible for completing the school health history form on behalf of their minor children. This ensures that the school has access to important medical information that may be necessary in case of an emergency.
03
School administrators and healthcare professionals: The school health history form is a valuable resource for school administrators and healthcare professionals within the educational institution. It allows them to be aware of any medical conditions or special needs that students may have, enabling them to provide appropriate care and support if necessary.
Note: The specific requirements and processes for completing a school health history form may vary depending on the school or educational institution. It is important to follow any additional instructions provided by the school and to provide accurate and up-to-date information.
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What is school health history form?
The school health history form is a document that collects important information about a student's health history, including any medical conditions, allergies, medications, and past illnesses.
Who is required to file school health history form?
Parents or legal guardians are typically required to fill out and file the school health history form for their child.
How to fill out school health history form?
Parents or legal guardians can fill out the school health history form by providing accurate and detailed information about their child's health history, medical conditions, allergies, medications, and past illnesses.
What is the purpose of school health history form?
The purpose of the school health history form is to ensure that schools are aware of any medical conditions or concerns that may impact a student's health or well-being while at school.
What information must be reported on school health history form?
The school health history form typically requires information about a student's medical conditions, allergies, medications, and past illnesses.
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