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
Husky - Healthcare for Uninsured Kids and Youth