Health Office Forms
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Below are resources and forms that pertain to Health Offices within the Northern Lehigh School District.
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Emergency Health Office Form (High School)
This form must be completed by a Parent/Guardian to advise the Health Office on a student's allergies and medications, as well as a student's history of serious illness, operations, or other special health concerns. The form also specifies a student's Emergency Contact Person. The information on this form is confidential and will remain on file in the Health Office.
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Emergency Health Office Form (Middle School)
This form must be completed by a Parent/Guardian to advise the Health Office on a student's allergies and medications, as well as a student's history of serious illness, operations, or other special health concerns. The information on this form is confidential and will remain on file in the Health Office.
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Medical History and Immunization Records
The information requested on this form will be of assistance to the school district in determining the health status of your child and assisting him/her to receive maximum benefits from this educational opportunity.
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Immunization Requirements
This document details vaccination requirements that will apply to all students in the Northern Lehigh School District.
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Dental Form
Private Dentist Report of Dental Examination of a Pupil of School Age.
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Private Dentist Examination Form
The Pennsylvania School Health Act requires a dental examination of every student entering school for the first time, third grade and seventh grade. The Law gives you a choice of having the examination done by the school dentist or by your family dentist at your own expense.
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Private Doctor Examination Form
The Pennsylvania School Health Act requires a medical examination of every student entering school for the first time, sixth grade and eleventh grade. The Law gives you a choice of having the examination done by the school physician or by your family physician at your own expense.
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Private Physician's Report of Physical Examination
This form must be completed and certified by an Authorized Medical Examiner for all pupils of school age.
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Private Physician Request for Administration of Medication During School Hours
This form must be completed by a Parent/Guardian and signed by a Physician to allow the Health Office to administer medication to a student during school hours. Some information requested on this form includes the name of the medication, dosage, administration schedule, possible side effects, and additional medication taken by the student.