This form is to be completed by the private physician during a wellness visit or an annual physical exam.  This form does not suffice for a sports exam. 

Private Physicals are requested during the developmental years, specifically grades 1-3-5 & 7. 

A sports exam may suffice for a private physical exam.

Any student who needs to receive medication during the school day(including class trips) must have this form on file.

• Includes any prescription/nonprescription/supplement/or herbal product.
• Students may not carry their own medications.
• Students may carry EpiPens, twinjects, inhalers, and insulin/glucagon for emergency use only.