link to Connecticut Technical High School System web site
Vinal Technical High School, 60 Daniels Street, Middletown, CT 06457
 
Telephone: (860) 344-7100, FAX: (860) 344-2622

 

SCHOOL NURSE

Debra Ismael

 

Debra Ismail
Telephone: (860) 344-7100 Ext. 318
E-mail: Debra.Ismail@ct.gov

The health office has a new secure (confidential) fax line.
Please fax all medical notes and forms to:
860-344-2232

Concussion in High School Sports:  A Fact Sheet for Parents

FORMS
(All of the 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

Health Assessment Record (HAR3)


GENERAL
Health Assessment Record (HAR3)
Health History, Emergency Contact and Non-Prescription Medication Form
Immunization Record
Medication Authorization Form
Medical Exemption Form
Religious Exemption Form

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