Health Forms: Central High School 
Please contact the CHS health office at 609.737.4003 x3538 if you have questions.

Click here to view descriptions of all health forms.

 Central High School Health Forms

ConfidentialHealthHistory.pdfH-01Health History
PreParticipationPhysicalExam.pdfH-02aPhysical Examination Form / Athletic Pre-Participation Form
PermissionToDiscloseMedicalInfo.pdfH-03Permission to Disclose Medical Information
AdministrationOfMedsInSchool.pdfH-04Request for Administration of Medication in School
EmergencyMedicationAuthorization.pdfH-05Authorization for Administration of Emergency Medication
ParentPermissionDelegateEmergTrtmntAllergicReaction.pdfH-06Authorization for Emergency Treatment of Allergic Reaction
RequestEmergAdminEpi.pdfH-07Authorization for Emergency Administration of Epinephrine
AllergyQuestionnaire.pdfH-09Allergy Questionnaire
AllergyActionPlan.pdfH-10Allergy Action Plan
AsthmaQuestionnaire.pdfH-11Asthma Questionnaire
AsthmaTreatmentPlan.pdfH-12Asthma Treatment Plan
SeizureQuestionnaire.pdfH-13Seizure Questionnaire
AcetaminophenIbuprofenPermission.pdfH-14Authorization for Administration of Acetaminophen / Ibuprofen
HealthHistoryUpdateAthletics.pdfH-15Health History Update for Athletic Participation
 
Hopewell Valley Regional School District   |   425 S Main St. Pennington, NJ 08534   |   tel 609.737.4000   |   fax 609.737.1418