Health Form

Parents must fill out this form as thoroughly as possible as it will be the first reference to be used by our infirmary staff if needed. Attach immunization records.

What language does your child better communicate in?
If other, which?

In case of emergency, list who is to be reached in order of priority

Is your child currently undergoing medical treatment
Does your child take any medication regularly?
Does your child have allergic reactions.
If you answered YES to any of the questions above, please explain below: