Health Forms

WDMCS requests examinations and medical reports annually of all preschoolers, kindergartners, third-graders, sixth-graders, and all new students. Health Services should also be notified if any student has a known health problem.

Downloadable Health Forms

• Certificate of Dental Screening
• Certificate of Vision Screening
• Diet Modification Request
• Food and Allergy & Anaphylaxis Emergency Care Plan
• Health History Form
• Inhaler Self-Carry Consent
• Immunization Requirements
• Lead Policy | ¿Qué es el envenenamiento por plomo en la niñez?
• Medication Form
• Physical Examination Form (Please note: this is not the athletic physical form)
• Seizure Action Plan Form

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Health Forms by Grade Level

Kindergarten

• Immunization Requirements
• Health History Form
• Physical Form (Please note: this is not the athletic physical form)
• Vision Screening
• Dental Screening Form
• Lead Policy 

Grades 1-6—New Students

• Immunization Requirements
• Health History Form

Third Grade

• Vision Screening

Seventh and Eighth Grade

• Health History Form
• Evidence of Tdap Vaccine after age seven
• Athletic Physical Exam

Seventh and Eighth Grade—New Students

• Health History Form
• Immunization Requirements
• Evidence of Tdap Vaccine after age seven
• Athletic Physical Exam

Ninth Grade

• Immunization Requirements
• Health History Form
• Dental Screening Form

Grades 10-12

• Immunization Requirements
• Health History Form