Student Health Forms

School Health Services Medical Forms


Forms for Doctors’ Physicals

Forms for Administering Medicine at School

Medications can be given at school if parent has signed a permission form and brought in the student’s medication. School nurses will also get confirmation from the student’s physician before giving the medication, whether prescription or non-prescription.

Release of Information Forms

These forms allow release of confidential medical information on a student between the school and the student’s health care provider. It is required that the form be signed by the child’s parent or guardian before medical institutions can provide any information to the school nurse regarding the child’s health or any activity restrictions. Likewise the school nurse cannot contact a health care provider directly on behalf of a student without a signed release form.

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To Learn More

Dr. Kendra King
Director of Student Services and Achievement
1562 Dairy Road
Charlottesville, VA 22903
(434) 245-2400