The Country School

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    School Health Forms


    Click on a form to view it. If you would like to download the form, right-click on the name and then select "Save Target As..." from the drop-down menu. Choose a location to save the form and then click "Save"

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    Medication Administration Forms

    In-School Medication Form

    Overnight Medication Form


    Lower School Health Forms

    Health History Update: PreK-Grade 4

    Permanent Permission Slip

    Health Assessment Record (PreK only)

    Health Assessment Record (K-4)


    Middle School Health Forms

    Health History Update: Grade 5-8

    Permanent Permission Slip

    Health Assessment Record

    Sports Participation Health Record


    Health Release from Physical Education

    Release from Lower School PE

    Release from Middle School PE


    Specific Health History Updates

    Food / Nut Allergy History

    Healthcare Plan - Food Allergy



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