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Health Forms
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Below are forms and documents for health/medical information in PDF format. If you have any questions about these forms please contact Mary Rooney at (763)497-3887 x406 or email [email protected].
Parent Absence Notice Form - for parents going out of town and leaving their children in the care of another adult
History and Physical Exam - for Kindergarten registration
Medication Authorization - for all medications administered in school, prescription and over-the-counter
No Shots, No School Initiative - for Kindergarten, 7th Grade & New Student registration
Minnesota Immunization Requirements and Exemption Form - for registration we need either their Immunization Record from the clinic or this exemption form
Allergy Action Plan Form - Parent and physician signatures are BOTH required.
Asthma Action Plan Form- Parent and physician signatures are BOTH required.
Health Management Plan Form- Parent and physician signatures are BOTH required.
Special Diet Statement - Parent and physician signatures are BOTH required.