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Health Forms to Download

Below are various health forms that are used throughout the school year.  Please print and fill out the form that you need and turn it into the school office.  Forms can also be faxed to 309-446-9500 or scanned and emailed to lsumner@brimfield309.com.  All forms need to be updated each school year.

 

 

HEALTH EXAMINATION FORMS

Dental Exam Form

Vision Exam Form

Health Physical Exam Form

Sports Physical Form

 

EXAMINATION WAIVER FORMS

Religious Exemption Form

 

SCHOOL MEDICATION FORMS

Over the Counter medication authorization form

Prescription Medication Authorization Form

Asthma Medication Release Form

 

 

If you have any questions regarding health forms that may be needed for your child, please contact Lonna Sumner, RN at 309-446-3366 x 1119 or lsumner@brimfield309.com.

 

 

 

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