Health Questionnaire
Please check YES or NO to the following questions below to determine if you need to fill in additional Health Forms. The additional Heath Forms must be downloaded as they require a prescriber’s/Doctor’s Signature. You may then upload them back to our website. Please click on the appropriate link to each question to access the corresponding Health Form. You may also access these forms on our home page on the FORMS Tab.
1. Does your child take any Medications?
YES (Please fill in FORM A)*
NO
2. Does your child have any Allergies?
YES (Please fill in FORM B)*
3. Does your child have Asthma?
YES (Please fill in FORM C)*
4. Does your child have any Seizures/Convulsions or Epilepsy?
YES (Please fill in FORM D)*
5. Does your child require any Individualize Treatment/Care Plan?
YES (Please fill in FORM E)*
