Forms
physical Form
Physical Examinations are required for:
- Pre-K
- Kindergarten
- Second Grade
- Fourth Grade
- Seventh Grade
- Tenth Grade
- Special Education Students – every 3 years
- All New Entrants
It is recommended that your child's physician provide these well child exams. He/she is the one who best knows the family and is better able to judge any changes in the child's state of health. New York State based health insurance entitles children to an annual well child check-up and mandatory immunizations.
Below you will find the 2 part physical form used by the East Syracuse Minoa School District.
- The HEALTH HISTORY part is completed by the parent or guardian.
- The PHYSICAL FORM or HEALTH APPRAISAL FORM is completed by your physician.
Please complete both parts and return it to the school nurse.
PHYSICAL FORM (HEALTH APPRAISAL)
HEALTH HISTORY - health_history_for_elementary.pdf
MEDICATION FORMS
MEDICATION FORM - medical_form.pdf
ALLERGY CARE PLAN - allergy_action_plan.pdf
DENTAL CERTIFICATES
On September 1, 2008, a law was enacted that expands health screenings to include the dental health of the students. After September 1, 2008, when it is required that your child have a physical examination, we are requesting a dental certificate as well. A sample dental certificate is attached for you to take to your child's dentist.
Once it is completed, it should be returned to the school nurse.
DENTAL CERTIFICATE - dental_certificate.pdf
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