HEALTH INFORMATION FROM THE SCHOOL NURSE
School Nurse - Francine Raineault Tel. (860) 827-7736 ext. 323 E-mail: Francine.Raineault@ct.gov
Forms (All forms are in Adobe Acrobat format. Download the FREE Adobe Acrobat Reader.)
SPORTS Important Information about Sports Physical Sports Physical Form - Side A Sports Physical Form - Side B
Espanol (Spanish) Importante Nota Sobre Examenes Fisicos de Deportes Formulario Inter-escolar Atletico con Historial, Consentimiento Paternal y Relevo Medico - A Formulario Inter-escolar Atletico con Historial, Consentimiento Paternal y Relevo Medico - B GENERAL
Emergency Information for School Nurse Form
Health Assessment Form
Health History and Emergency Contact Form
Immunization Record
Medication Authorization Form
Medical Exemption Form
Notes from the School to Parents/Guardians of Incoming 9th Grade Students
Religious Exemption Form