Health Office Forms
Page Updated: August 24, 2016
Below are various forms that may apply to any or all Northern Lehigh Middle School students and parents. Upon completion, these forms will remain on file in the high school Health Office.
This form must be completed by a Parent/Guardian to advise the Health Office on a student's allergies and medications, as well as a student's history of serious illness, operations, or other special health concerns. The information on this form is confidential and will remain on file in the Health Office.

This form must be completed by a Parent/Guardian and signed by a Physician to allow the Health Office to administer medication to a student during school hours. Some information requested on this form includes the name of the medication, dosage, administration schedule, possible side effects, and additional medication taken by the student.

This form must be completed and certified by an Authorized Medical Examiner for all pupils of school age.

Private Dentist Report of Dental Examination of a Pupil of School Age.

This document details vaccination requirements that will apply to all students in the Northern Lehigh School District.