Please call the Attendance number to report your child's absence.
HELPFUL LINKS Information on Pediculosis Fact Sheet on Pediculosis
FACT - Food Allergy Committee for Tolerance Immunization Schedule
FORMS The forms below have been posted in Adobe Acrobat (pdf) format and can be viewed by clicking the form link. If you don't already have the free Adobe Acrobat Reader software on your computer, click here to download it. Emergency Contact Form
100 - Health/Medical Information
100 - Health History
102 - Elementary Physical Exam Form
103 - "A" Form
104 - "B" Form
105 - Dental Health Report
109 - Confidential Health Concerns
109-R - Confidential Health Concerns Reminder
110 - Pre-School Lead Screening Requirement
Food Allergy Action Plan
EpiPen Checklist
200 - Immunization Forms
200 - Immunization Record
202 - Immunization MMR#2 Requirement
202-R - Immunization MMR#2 Requirement Reminder
203 - Immunization Chicken Pox Requirement
203-R - Immunization Chicken Pox Requirement Reminder
204 - Immunization Tdap Requirement
204-R - Immunization Tdap Requirement Reminder
300 - Medication Forms
300 - NYS Guidelines for Administration of Medication
301 - Parent Authorization for Medication
302 - Physician's Order-Parent Authorization for Medication
303 - Self Medication Release Form
400 - Referral Forms
401 - Vision Referral
402 - Vision Referral Update
403 - Color Perception Referral
405 - Hearing Referral
407 - Scoliosis Referral
500 - Assistive Device Forms
501 - Guidelines for Protective/Assistive Devices
502 - Guidelines on Using Crutches
900 - Miscellaneous
904 - Elementary Health Office Numbers
905 - Release of Confidential Information
Welcome to Lakeville's Health Office
