Get H511336

Filling out the H511336 form is essential for documenting the health history of school-age students. This guide provides a step-by-step approach to ensure that you complete the form accurately and efficiently, making the process as straightforward as possible for all users.

Follow the steps to successfully complete the H511336 online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by filling out the student's information at the top of page one, including their name, today’s date, date of birth, and age at the time of the exam.
3. Fill in the student's gender by selecting either 'Male' or 'Female.' Additionally, list any medicines and allergies under the corresponding sections.
4. Complete the general health section by checking 'YES' or 'NO' for each ongoing medical condition. If applicable, identify specific conditions such as asthma or diabetes.
5. If the student is female, answer the questions regarding menstrual history, including the age of the first period.
6. Continue filling out the dental and social/learning sections, answering questions about dental visits and any learning disabilities or behavioral concerns.
7. Proceed to the family health section, checking all relevant family medical histories that may affect the student.
8. In the questions or concerns section, note any specific topics the student, parent, or guardian wishes to discuss with the health care provider.
9. After completing all sections, ensure that the parent, guardian, or emancipated student signs and dates the form to certify all information is accurate.
10. Finally, save your changes, and download or print the completed form to take to the student's appointment.

Complete the H511336 form online to ensure your student’s health is properly documented.