Student Health FormStudent Health FormStudent First NameStudent Last NameGradeName of person completing the medical information update.Email address of the person completing the medical information updatePhone number of the person completing the medical information updateList any allergies the student has.List any special conditions the student has.I give permission for my child to be administered the following over-the-counter medications provided by the school. Cough Drops Ibuprofen (Advil, Motrin) Acetaminophen (Tylenol) Antacid (Tums) Diphenhydramine HCL (Benadryl) Ambesol Sore Throat Spray Sunscreen Insect Repellant OtherIf "Other," please specify:Physician InformationDoctor's NameDoctor's Phone NumberDental InformationDentist's NameDentist's Phone NumberSubmit Form
