News & Calendar

Medical and Other Forms

(Tip: Copy all medical forms before you submit them.)
Forms for all students due by first day of school, 08/23/17

Return forms to the nurse's office in the building where this child will attend
Scan and Email
Fax
Postal Mail

EBL Elementary School Building
(PK2 - Grade 3):

EBLNurse@chca-oh.org (513) 247-0125 11312 Snider Road 45249
Founders' Campus Building: FCNurse@chca-oh.org (513) 247-9362 11300 Snider Road 45249
MSL High School Building: MSLNurse@chca-oh.org (513) 247-0982 11525 Snider Road 45249
Armleder School Building: ASNurse@chca-oh.org (513) 721-3300 140 West 9th Street 45202

Medical Forms Required 2017-2018

Grade PK

School Forms (Grade PK)

PK only Authorization for Emergency Response

PK only Medical History (required)

PK only Medication Perm (OTC & Rx Meds) (optional)

PK-12 Asthma Information Sheet (as needed)

PK-12 Severe Allergy Policy, Letter (sign & return), Emergency Care Plan (as needed)

PK-12 Seizure Action Plan

PK only Immunization Requirements Info

Grades K-5

School Forms (Gr K-12)

K-12 Authorization for Emergency Response
×

Authorization for Emergency Response

Families of students enrolled in CHCA by July 31 receive a secure, personalized link via eMail to provide their Information Update online, which automatically generates the Authorization for Emergency Response and delivers it to the nurse in your child’s building.

If you are enrolling August 1 or later, we welcome you! You will receive a PDF version of this form from your building nurse or your admissions counselor.

Please email your building nurse with any questions.

K-12 Medication Permission (OTC & Rx Meds) (optional)

K-12 Immunization Requirements info

PK-12 Asthma Information Sheet (as needed)

PK-12 Severe Allergy Policy, Letter (sign and return), Emergency Care Plan (as needed)

PK-12 Seizure Action Plan

Gr 7-12 only - Tdap information form (required all Gr 7 and new Gr 8-12)

Gr 7-8 and 12 only - Meningitis information form (required for all Gr 7-8 and all Gr 12)

Athletics Medical Forms (Gr K-5)

Medical information is collected online during registration.

Grades 6-8

School Forms (Gr K-12)

K-12 Authorization for Emergency Response
×

Authorization for Emergency Response

Families of students enrolled in CHCA by July 31 receive a secure, personalized link via eMail to provide their Information Update online, which automatically generates the Authorization for Emergency Response and delivers it to the nurse in your child’s building.

If you are enrolling August 1 or later, we welcome you! You will receive a PDF version of this form from your building nurse or your admissions counselor.

Please email your building nurse with any questions.

K-12 Medication Permission (OTC & Rx Meds) (optional)

K-12 Immunization Requirements info

PK-12 Asthma Information Sheet (as needed)

PK-12 Severe Allergy Policy, Letter (sign and return), Emergency Care Plan (as needed)

PK-12 Seizure Action Plan

Gr 7-12 only - Tdap information form (required all Gr 7 and new Gr 8-12)

Gr 7-8 and 12 only - Meningitis information form (required for all Gr 7-8 and all Gr 12)

Athletics Medical Forms (Gr K-5)

Medical information is collected online during registration.

Class Trips (Gr 6-8)

Gr 6-8 STU Health Form for Domestic Overnight Trip
Gr 6 – PVM Camp - Fall 2017
Gr 8 – Washington, D.C. - Fall 2017

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Gr 6-8 STU Health Form Instructions

Families of students enrolled in CHCA by July 31 receive a secure, personalized link via eMail to provide their Information Update online, which automatically generates the Gr 6-8 STU Health Form for Domestic Overnight Trip and delivers it to the nurse in your child’s building.

If you are enrolling August 1 or later, we welcome you! Prior to your student's class trip, please contact your building nurse to obtain a paper version of this form to complete.

Email your building nurse with any questions.

Gr 7-8 STU Health Form for International Travel
Gr 8 –Mexico Mission Trip (if participating) – due October 2017

Athletics Medical Forms (Gr 7-12)

Return the paper OHSAA Physical pages 3 & 4 to the Athletic Office located by the gym in the building where your student will attend classes. These require a doctor signature.

Either:

Grades 9-12

School Forms (Gr K-12)

K-12 Authorization for Emergency Response
×

Authorization for Emergency Response

Families of students enrolled in CHCA by July 31 receive a secure, personalized link via eMail to provide their Information Update online, which automatically generates the Authorization for Emergency Response and delivers it to the nurse in your child’s building.

If you are enrolling August 1 or later, we welcome you! You will receive a PDF version of this form from your building nurse or your admissions counselor.

Please email your building nurse with any questions.

K-12 Medication Permission (OTC & Rx Meds) (optional)

K-12 Immunization Requirements info

PK-12 Asthma Information Sheet (as needed)

PK-12 Severe Allergy Policy, Letter (sign and return), Emergency Care Plan (as needed)

PK-12 Seizure Action Plan

Gr 7-12 only - Tdap information form (required all Gr 7 and new Gr 8-12)

Gr 7-8 and 12 only - Meningitis information form (required for all Gr 7-8 and all Gr 12)

Class Trips (Gr 9-12)

May Term 2018 forms - see course instructor for due date

Gr 9-12 STU Health Form for International Travel (required )

Gr 9-12 STU Self Medication Agreement (required only if student needs medication while off campus)

Athletics Medical Forms (Gr 7-12)

Return the paper OHSAA Physical pages 3 & 4 to the Athletic Office located by the gym in the building where your student will attend classes. These require a doctor signature.

Either: