Medical Forms

Fax Medical Forms:
510-794-2408

Contact Student Health Unit:
510-794-3748 voice | 510-344-6111 videophone | 510-673-0460 text

Physical Exam
English
Kindergarten; 6^th grade; 9^th grade

Parental Permission
English | Spanish
17 to 18-year-olds

Authorization to Administer Medication
English | Spanish
If child takes meds

EpiPen and Inhaler
English | Spanish
If child uses EpiPen or Inhaler

Emergency Sick Day Orders
English | Spanish
If applicable

Dental Exam
English | Spanish
Kindergarten; 1^st grade

TB Clearance Form
English
Under 18

Scoliosis Screening
English | Spanish
7^th grade girls; 8^th grade boys

Immunizations
Current California Immunizations | Shots for School

Diabetes Information
English | Spanish
7^th graders

Special Meal Request Form
English

Sports Medical Consent Form
English

Student Health Unit
General Information
English