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MUTILATED SCHOOL DISTRICT | STUDENT HEALTH SERVICES INTAKE FORM Student name: (last)___ (first)___ Birthdate: ___ Grade: ___ Oboes your student have a LIFE-THREATENING health condition? Yes None conditions
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Obtain the student health form from the Mukilteo School District website or office.
02
Fill in the student's name, date of birth, and other personal information.
03
Provide information about the student's medical history, including any allergies or chronic conditions.
04
Include emergency contact information for a parent or guardian.
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Sign and date the form to certify the accuracy of the information provided.

Who needs mukilteo school districtstudent health?

01
All students attending schools in the Mukilteo School District are required to fill out the student health form.
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Mukilteo School District student health refers to the health services and programs provided to students within the Mukilteo School District to promote their physical, mental, and emotional well-being.
Students and their guardians are typically required to file student health forms with the Mukilteo School District to ensure appropriate health services are provided.
To fill out the Mukilteo School District student health forms, parents or guardians should complete the required sections regarding the student’s medical history, current medications, and any special health needs, then submit it to the school.
The purpose of Mukilteo School District student health is to ensure the safety and well-being of students, provide necessary health services, and support their academic success through health management.
Information that must be reported includes the student's medical history, allergies, current medications, immunization records, and any chronic health issues.
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