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Health Forms Available

Wednesday, June 7, 2017

Health forms are now available in our SchoolForms Online module. Click SchoolForms Online (upper right hand navigation) to access the forms.

Click on an item below to expand and view details about the various required health forms.

Emergency Medical Authorization (EMA)

This electronic form must be updated each academic year for every student, it does not require a physician's signature, and does not need to be printed. The EMA contains the following information:

  • physician/dentist/insurance information
  • parent/guardian consent or refusal of consent to medical treatment
  • non-parent/guardian emergency contact information
  • Tuberculosis (TB) information

 

Medical Record (MR)

The medical record (MR) form is a record of each student's immunization and medical history. This form must be completed and signed by a physician. An updated medical record is required for:

  • all new students - current medical record with immunizations
  • all PRE-K students - annual updates are required - see "Date of Last Physical Exam" on the MR form
  • all KDG students - updated immunizations required - see Ohio Department of Health (ODH) guidelines below
  • all 7th grade students - need proof of current Tdap and Meningococcal prior to entry
  • all 12th grade students - need proof of current Meningococcal prior to entry
  • all other students - required if any new immunizations or changes
  • ODH immunization guidelines

 

Consent to Administer Over the Counter Medication

This form is required for any student who may need to receive any listed over-the-counter (OTC) medications during the year.

Consent to Administer Prescription Medication

Any student needing prescription medication during the school day must have a completed medication consent form. This form requires signatures from an MD and a parent/guardian.

Ohio High School Athletic Association Pre-Participation Form

The state of Ohio requires any student in grades 7-12 who wishes to participate in a school sport to complete a pre-participation form. This form requires signatures from the student, a parent/guardian and a physician.