School District No. 36 (Surrey) FIELD STUDIES MEDICAL FORM FOR OUTDOOR AND/OR OVERNIGHT AND/OR OUT OF PROVINCE Name of Student Grade Division Care Card Personal Health No. Date of Birth Family Doctor.
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How to fill out the Field Studies Medical Form - Surrey Schools online
Filling out the Field Studies Medical Form is essential for ensuring the safety and well-being of students during outdoor, overnight, or out-of-province trips. This guide will provide clear, step-by-step instructions on how to complete the form accurately online.
Follow the steps to fill out the form effectively.
- Press the ‘Get Form’ button to access the Field Studies Medical Form and open it for editing.
- Begin by entering the name of the student, their grade, and division in the assigned fields. Ensure accurate spelling and correct grade information.
- Fill in the details of the family doctor, including their name and phone number.
- Enter the name and address of the parent or guardian. Include home, business, and cell phone numbers for effective communication.
- In case of an emergency, list the name and phone number of a contact person in addition to the parents or guardians.
- Note any health issues or factors affecting the child's full participation in the program. If necessary, utilize the back of the sheet for additional information.
- Indicate if the student has had a prior injury that may require special first aid. Provide explanations in the designated space.
- Circle ‘Yes’ or ‘No’ regarding the student’s immunization history for diphtheria, pertussis, and tetanus; tetanus and diphtheria; polio; and measles, mumps & rubella.
- Circle ‘Yes’ or ‘No’ for contact lens usage.
- Check any pre-existing health conditions that apply to the student, including asthma, allergies, or other concerns. Provide descriptions as needed.
- List any medications the student is taking, including the name, purpose, administering details, quantity, and permission granted by the guardian.
- Provide permission for treatment by a physician in case of an emergency. Obtain the parent's or guardian's signature and date the form.
- Review all entered information for accuracy. Once complete, save the form, download it, print it or share it as required.
Complete your Field Studies Medical Form online today to ensure a smooth and safe experience for your child.
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