Link to Connecticut Technical High School System
A.I. Prince Technical High School 401 Flatbush Avenue, Hartford, CT 06106
 
Telephone: (860) 951-7112, FAX: (860) 951-1529
School Nurse
Order Uniforms
Connecticut State Department of Education

 

HEALTH INFORMATION
FROM THE SCHOOL NURSE

School Nurse - Eileen Devine
Telephone: (860)
257-5109
E-mail:
Eileen.Devine@ct.gov

Forms
(All forms are in Adobe Acrobat format.
Download the FREE Adobe Acrobat Reader.)

SPORTS
Important Information about Sports Physical
Note: The Interscholastic Athletics Health History, Permission & Physician’s Release Form must be signed by both parent and student's medical provider. A copy of the most recent physical exam must also be attached and returned to the School Nurse.
Interscholastic Athletics Health History, Permission & Physician’s Release Form

Espanol (Spanish)
Importante Nota Sobre Examenes Fisicos de Deportes

Formulario Inter-escolar Atletico con Historial, Consentimiento Paternal y Relevo Medico


GENERAL
Health Assessment Record (HAR3)
Immunization Record
Medical Exemption Form
Medicine Authorization Form
Religious Exemption Form

Husky - Healthcare for Uninsured Kids and Youth
- Healthy Children.org