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Questionnaires

Allergy

Allergy Questionnaire ENG- SPAN.docx 90.23 KB (Last Modified on May 19, 2020)

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Asthma

Asthma Questionaire Revised 2015.doc 104 KB (Last Modified on May 19, 2020)

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Heart

Heart Defect Questionnaire.pdf 16.67 KB (Last Modified on September 18, 2017)

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Seizure

Seizure Questionnaire.pdf 19.93 KB (Last Modified on September 18, 2017)

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Health Examination Form

Health Examination Form - English

New Student Physical Form Eng.pdf 32.01 KB (Last Modified on September 18, 2017)

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Health Examination Form - Spanish

New Student Physical Form Span.pdf 35.65 KB (Last Modified on September 18, 2017)

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Instructions to Request a Medical Exemption

Instructions to Request a Medical Exemption.pdf 519.21 KB (Last Modified on August 2, 2023)

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Instructions to Request a Medical Exemption - Spanish

Instructions to Request a Medical Exemption-Spanish.pdf 452.17 KB (Last Modified on August 2, 2023)

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Release of Information

Release of Information - English/Spanish

PSUSD_-_ROI_-_Authorization_of_Release_of_Information_-_NEW 4.12.19.pdf 389.93 KB (Last Modified on May 19, 2020)

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Medi-CAL Consent

Parent Consent Form and FAQs - English

Parent Consent Signature Form and FAQs - English.pdf 763.97 KB (Last Modified on April 27, 2023)

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Parent Consent Form and FAQs - Spanish

Parent Consent Signature Form and FAQs - Spanish.pdf 154.79 KB (Last Modified on April 27, 2023)

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Meal Accommodation Form

Meal Accommodation Form

Special Meals Accommodation.pdf 271.6 KB (Last Modified on May 19, 2020)

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DOHC Registro de pacientes con consentimiento

DOHC Registro de pacientes con consentimiento.pdf 691.62 KB (Last Modified on September 22, 2023)

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DOHC Consent Patient Registration

DOHC Consent Patient Registration ENG..pdf 691.19 KB (Last Modified on September 22, 2023)

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Medication Forms

Emergency Seizure Medication Order Form

Emergency Seizure Medication Order Form.pdf 327.84 KB (Last Modified on July 26, 2023)

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Casts and Crutches

Casts and Crutches . New 003.pdf 120.79 KB (Last Modified on June 10, 2022)

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Authorization for Specialized Physical Health Care

AUTHORIZATION FOR SPECIALIZED PHYSICAL HEALTH CARE PROCEDURE.docx 20.62 KB (Last Modified on May 19, 2020)

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Allergy Action Plan - Epi Pen

Allergy Action Plan for MD.doc 204 KB (Last Modified on May 19, 2020)

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Authorization for Medication Spanish

Auth for Medication Admin - Spanish 20.docx 51.58 KB (Last Modified on May 19, 2020)

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Authorization for Medication English

Auth for Medication Admin - English 20.docx 45.45 KB (Last Modified on May 19, 2020)

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Immunization Resources

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