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 History

New Preschool Students

All NEW preschool students must submit the Student Health History and PreSchool Physical Exam and Imm Rec.

Flu Vaccine Requirement Letter

PLEASE NOTE: Per state law, all preschool students (aged 59 months and under) MUST provide documentation of a flu shot by December 31 of the current year.

All KINDERGARTENERS

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

Requirements for All Sixth Graders

All sixth graders must provide documentation of Tdap and Meningococcal vaccinations prior to the first day of school. Please read this 6th Grade Parent Letter 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

Student Health History

Private Physician’s Exam Report

PreSchool Physical Exam and Imm Rec.

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

• Med Administration in School Requirements
• Med Administration Form
• Epi – List of Required Docs
• Epi 1- Physician Permission
• Epi 2- Parent Permission
• Epi 3- Emergency Health Care Plan
• Asthma Treatment Plan ENG B&W
• Asthma School Record
• Asthma Letter PDF