Health Forms

***Updated Vaccination Policy and Procedures of Pittsburgh's Three Jewish Day Schools***

Parental Application for Medical Exemption

Physicians Medical Exemption Certificate

A physical examination report is required for all students entering the Early Childhood, Kindergarten, 6th grade, and 9th grade as well as for all new students.

These reports are to be filled out by your child's physician and returned by the start of school.

Physical Examination Report for all ECC Students

Physical Examination Report for Students in Grades K-12

 

Lead Test Form

 

Immunization Regulations for ECC Students

Immunization Regulations for Students in Grades K-12

 

Additionally, all new students as well as returning students entering Nursery, Kindergarten, 3rd Grade and 7th Grade must have a completed Dental Exam Form.

Dental Examination Form 

 

Emergency action plans are to be returned to the Hillel Office by the start of school.

Anaphylactic Action Plan

Asthma Action Plan

Child Diabetic Action Plan

Teen Diabetic Action Plan

Seizure Action Plan

Diastat - Seizure Action Plan

 

If your child is able to administer his/her own rescue medication, please fill out this form and return it to the Hillel Office by the start of school

Rescue Medication Access Permission Form

 

Miscellaneous Forms:

Infant Feeding InformationPermission to Administer Creams, Powders, and Lotions to Tiny Tots and Toddlers