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State of California Health and Human Services Agency Department of Health Services Child Health and Disability Prevention Program CHIP ANNUAL SCHOOL REPORT See instructions on reverse side. 1. School
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How to fill out health examination for school

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How to fill out health examination for school?

01
Obtain the health examination form from your school or school district. It is usually available online or can be picked up from the school office.
02
Begin by providing your personal information, such as your name, date of birth, and contact details. Make sure to double-check for any spelling errors or missing information.
03
Fill out the medical history section honestly and accurately. Include any previous illnesses, surgeries, or chronic conditions you might have had. Remember to indicate any medications you are currently taking.
04
Complete the immunization record section. Provide the dates of the vaccines you have received, including the specific vaccines required by your school or district.
05
If you have any known allergies, ensure that you include them in the appropriate section. Specify the allergen and the severity of your allergies, if applicable.
06
The next section usually requires a physical examination performed by a healthcare provider. Make an appointment with your physician and have them complete the necessary information, which may include vital signs, vision, hearing, and overall health assessment.
07
Ensure that the healthcare provider signs and dates the form, as this validates the examination.
08
Submit the completed and signed health examination form to your school or designated location. Be sure to keep a copy for your records.

Who needs health examination for school?

01
Health examinations are typically required for students entering a new school or grade level. This may include students entering kindergarten, middle school, high school, or transferring from another district.
02
Additionally, health examinations might be necessary for students participating in specific activities or sports programs that require medical clearance, ensuring their well-being during physical exertion.
03
Some schools or districts may also require current students to undergo periodic health examinations to monitor their overall health status and ensure their ability to participate in various educational activities. Check with your school or district policy to determine if you fall within any of these categories.
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Health examination for school is a mandatory check-up to ensure students are healthy and fit to attend school.
Parents or guardians of students are required to file health examination for school.
Health examination for school can be filled out by a qualified healthcare provider or physician.
The purpose of health examination for school is to identify any health issues that may affect a student's ability to learn and participate in school activities.
Information such as medical history, vaccination records, physical examination findings, and any necessary follow-up recommendations must be reported on health examination for school.
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