School Health Forms

Commonwealth of Virginia School Entrance Health Form(PDF, 776KB)

APS School Entry Health Requirements and Forms

Sports Physical Examination from VHSL

Virginia School and Day-Care Minimum Immunization Requirements

• English | Spanish

Tuberculosis Risk Assessment Form (PDF)(PDF, 450KB)

Adrenal Insufficiency

• Adrenal Insufficiency Action Plan - Medication Authorization Form(PDF, 164KB)

Allergies

• Allergy Management and Support Guidelines
• Allergy Care Plan – Physician’s Order
  • Physician Order/Severe Allergy Action Plan – English
  • Physician Order/Severe Allergy Action Plan – Spanish

Asthma

• Asthma Action Care Plan(PDF, 295KB)  

Diabetes

• Virginia Diabetes Council
• ADA Diabetes Medical Management Plan (DMMP)(PDF, 753KB)

Seizures

• Seizure Action Plan(PDF, 253KB)

All Other Medications (including over-the-counter medications)

• Medication Authorization Form - English(PDF, 193KB)
• Medication Authorization Form - English and Amharic(PDF, 282KB)
• Medication Authorization Form - English and Arabic(PDF, 340KB)
• Medication Authorization Form - English and Bengali(PDF, 355KB)
• Medication Authorization Form - English and Mongolian(PDF, 209KB)
• Medication Authorization Form - English and Spanish(PDF, 207KB)

Medical Procedures

• Authorization for Medical Procedures

• Concussion Information
• Acute Concussion Evaluation Plan(PDF, 77KB)

• Bacterial Meningitis
• Frequently Asked Questions (Including clinic information, school policies and immunization requirements)
• Adolescent Health Issues
• Teen Health Clinic
• Flu
• How to Talk to Children about Health News
• Injury Prevention
• Physical Activity
• VHSL Sports Physical Examination Form
• Head Lice Information
• Human Papillomavirus (HPV) Vaccine English(PDF, 3MB) | Spanish(PDF, 3MB)