Medical Forms

Chinese Examination Form

English Examination Form

Korean Examination Form

Spanish Examination Form

Please have your doctor complete this form, required for Kindergarten, 6th and 11th grades.

Chinese Examination Form

English Examination Form

Korean Examination Form

Spanish Examination Form

Please have your doctor complete this form, required for Kindergarten, 3rd and 7th grades.

Chinese Medication Consent Form

English Medication Consent Form

Korean Medication Consent From

Spanish Medication Consent Form

All medications to be administered at school require prescriber and parental consent.

Allergy Health History Form

Asthma Health History Form

Diabetes Health History Form

Seizure Health History Form

Annual Health History Update Form 

Parents/guardians are requested to complete the Health History Update form each year in September.  Please note:  This is a "fillable" form. To use it properly, please open it, save it to your device (computer), edit it, re-save it, and then send it to either via email to your child's school nurse, fax (215-233-6001), or upload to your child's Health Portal.