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Health Forms for Returning Students

2013-2014 School Year

To download all forms for RETURNING students in one PDF file, click here.

All forms for returning students are due by August 1, 2013. If you have any questions regarding the forms, please contact the Health Center at 302-285-4240.

Deadline for Health Forms
Student Information and Medical Authorization – Page HCF-1
Health and Accident Insurance Form – Page HCF-2
Insurance and Care Provider Information – Page HCF-3
Example of Enlarged Copy of Insurance Copy
Patient Presents Without Legal Guardian Authorization for Treatment (Nemours) – Page HCF-4
Assignment of Benefits; Other Health Insurance; Patient Responsibility (Nemours) – Page HCF-5
Authorization for Treatment & Release of Information For Payment & Treatment Purposes; Receipt of Nemours’ Notice of Privacy Practice (Nemours) – Page HCF-6
Flu, Potassium Iodide, and Over-the-Counter Medication Forms – Page HCF-7
Tuberculosis (TB) Risk Assessment Questionnaire – Page HCF-8a & HCF-8b
Physician’s Medical Examination / Sports Physical – Page HCF-9
Delaware Interscholastic Athletic Association Parent/Player Concussion Information Form
Delaware Interscholastic Athletic Association (DIAA) – Page DIAA-1
DIAA Pre-Participation Physical Evaluation History – Page DIAA – 2
DIAA Pre-Participation Physical Evaluation/Examination – Page DIAA – 3
DIAA School Athlete Medical Card – Page DIAA-4
DIAA – Protect Your Athletic Eligibility – Page DIAA-5
Asthma Action Plan (only for students with Asthma)
Checklist for Submitting Health Forms (for RETURNING students only)

2013-14 Health Forms

New Students
Pertinent Information

One-Click Health Form Downloads

Returning Students
New Students
Pertinent Information 2013-2014

St Andrews School

Health Forms for Returning Students

2013-2014 School Year

2013-14 Health Forms

One-Click Health Form Downloads