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~[wc:admin_header_frame]~[wc:admin_navigation_frame] ~[wc:title_student_begin]Medical Information~[wc:title_student_end]
Home Phone ~(home_phone) Age  ~(age)
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Birth Date ~(DOB) Gender ~(Gender) Teacher ~(Primary_Teacher)
Father ~(Father) Daytime Phone  ~(FatherdayPhone)
Mother  ~(Mother) Daytime Phone  ~(Motherdayphone)
Doctor Phone Number  
ANY MEDICAL 
HEALTH ISSUES
ALLERGIES
ASTHMA TRIGGERS
MEDICAL ALERT
(Will be viewed by teachers)
Alert Expires (date)   (0/0/0 to never expire) DIABETIC 
Medications at home
Medications at school
Meds at School  Comunicable Diseases
Other
Consent To Treat 
IMMUNIZATION
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HIB  (Dates)      
HEPATITIS B  (Dates)    
VARICELLA (Dates)    
MMR  (Dates)    
MEASLES (Dates)    
RUBELLA  (Dates)    
MUMPS  (Dates)    
OTHER IMMUNIZATIONS
HEIGHT WEIGHT BMI>85%
LEAD ASSESMENT LEAD SCREEN LEAD RESULT
TB SKIN TEST DATE Test Results 
TB X-RAY DATE X-Ray Results  
Physical Exams  (Dates)
Dental Exams  (Dates)
SCREENING
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