Call Us: 856-667-1013

Required Medical Forms

Required Medical Forms

All medications and completed medical forms must be brought to school by a parent or guardian by the first day of school. Medical forms are available for download below. To request a hard copy, please email office@politz.org or call 856-667-1013. Any student whose parent or guardian has not submitted the completed, state-mandated forms prior to the first day of school WILL BE EXCLUDED from school until all requirements are met. 

ALL New Students

All new students from Toddler-8th Grade must submit the Student Health Inventory form.

New Preschool Students

All NEW preschool students must submit the Student Health Inventory form.
PLEASE NOTE: Per state law, all preschool students (aged 59 months and under) MUST provide documentation of a flu shot by December 31, 2020.

All KINDERGARTENERS

All incoming Kindergarten students (even those currently at Politz)  must submit the Health History & Appraisal Form.

Requirements for All Sixth Graders

All sixth graders must provide documentation of Tdap and Meningococcal vaccinations prior to the first day of school. Click Here for information. If you child has an appointment with the doctor past the first day of school, a note from the doctor or an appointment card with the date of exam is required before the first day of school.

FORMS

Immunization Requirement Information
Student Health Inventory – ALL KINDERGARTEN STUDENTS
Student Health Inventory – ALL NEW STUDENTS

The following forms are only required for students needing Epi-pens, Asthma Medications or other daily medications to be administered in school: