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How to fill out the Lyndhurst Public Schools Physician Referral Form
Filling out the Physician Referral Form for Lyndhurst Public Schools is essential to ensure that athletes receive the appropriate care. This guide will provide you with step-by-step instructions to complete the form accurately and efficiently.
Follow the steps to fill out the form correctly.
- Press the ‘Get Form’ button to access the Physician Referral Form and open it for editing.
- Enter the student's name in the designated field labeled 'Student Name.' Ensure you spell the name correctly.
- Fill in the 'Date of Injury' field with the appropriate date when the injury occurred.
- Specify the 'Sport' involved at the time of the injury.
- Provide a brief 'Description of Injury' in the corresponding section. Be concise yet descriptive enough for clarification.
- Complete the 'Diagnosis' section to communicate the official assessment of the injury.
- List any necessary 'Restrictions' that the athlete must follow, if applicable.
- Indicate whether the athlete may return to Physical Education and Athletics by selecting either 'Yes' or 'No.'
- Check the appropriate option to indicate if the athlete is cleared for 'Full Activity' or 'No Activity Until Re-evaluated.'
- If applicable, fill in the 'May return to participation on this date' field with the date the athlete is expected to resume activities.
- Add any additional 'Comments' that may be necessary for further clarification.
- Enter the physician’s name, and ensure you provide their signature in the specified fields.
- Fill in the physician's telephone number, and affix the physician's stamp in the designated area.
- Lastly, include the date of completion.
- Review the form for accuracy and completeness before submitting it back with the athlete or faxing it to the LHS School Nurse at (201) 935-3511.
Complete the Physician Referral Form online to ensure prompt care for athletes.
The best treatment for school refusal includes cognitive-behavioral therapy and increased parental support. Engaging with resources available through Lyndhurst Public Schools can also provide strategies for easing school anxiety. Working closely with teachers and counselors can help create a structured transition back to school, effectively addressing the child's concerns.
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