State of ct health forms for school
[DOCX File]FOOD BASED MENU PRODUCTION RECORD Version #1
https://info.5y1.org/state-of-ct-health-forms-for-school_1_16e100.html
in the Connecticut State Department of Education, Bureau of Health/Nutrition, Family Services and Adult Education, 450 Columbus Boulevard, Suite 504, Hartford, CT 06103-1841. This form is available at
[DOC File]Southington High School
https://info.5y1.org/state-of-ct-health-forms-for-school_1_d85f95.html
The State of CT Department of Education Health Assessment Record is now the Southington Sports Physical form as well. The sports physical is valid for thirteen (13) months. You may wish to plan ahead to schedule your child’s physical to coincide with any necessary sports physical for that school year.
[DOC File]Continue filling in the following information:
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5. HEALTH INSURANCE. If you have health insurance, put down the name and address of your health and/or dental insurance carrier, your policy number, and the names of the persons covered by the policy here. SUMMARY. Transfer the totals from boxes A - E to Sections 1, 2, 3 and 4 on the back. CERTIFICATION
[DOCX File]North Haven Public Schools
https://info.5y1.org/state-of-ct-health-forms-for-school_1_c12657.html
I hereby authorize school personnel to seek emergency medical care. If my child needs to be taken to the emergency room, I hereby authorize the physician in …
[DOC File]portal.ct.gov
https://info.5y1.org/state-of-ct-health-forms-for-school_1_381be9.html
Current Health Care Providers: Primary: Phone: Address: Last seen: Others: Include Dentist, Neurologist, Psychiatrist, Psychologist, Podiatrist, etc. (specify name, address, phone, and date last seen and frequency of review/follow-up visits). Health Specialty Address Phone Date Last Seen F/U Visit
[DOC File][Sample Authorization Form for Schools]
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*If a minor student is authorized to consent to health care without parental consent under federal or state law, only the student shall sign this authorization form. In Connecticut, a competent minor, depending on age, can consent to outpatient mental health care, alcohol and drug abuse treatment, testing for HIV/AIDS, and reproductive health ...
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