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Upcoming Events

Medical Forms

(Tip: Copy all medical forms before you submit them.)
Forms for all students due by first day of school, 08/21/19

Return forms to the nurse's office in the building where this child will attend
 
Scan and send encrypted 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

2019-2020

Grade PK

School Forms (Grade PK)

PK only Authorization for Emergency Response (electronic)

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 (as needed)

PK only Immunization Requirements Info

Grades K-6

School Forms (Gr K-12)

×

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 (as needed)

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

Gr 7-10 and 12 only - Meningitis information form (required for all Gr 7-10 and all Gr 12)

Class Trips (Gr 6)

Gr 6-8 Acknowledgement of Medication Policies for Overnight Trips
Gr 6 – PVM Camp - Fall 2019

 

Athletics Medical Forms (Gr K-6)

Medical information is collected online during registration.

Grades 7-8

School Forms (Gr K-12)

×

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 (as needed)

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

Gr 7-10 and 12 only - Meningitis information form (required for all Gr 7-10 and all Gr 12)

Class Trips (Gr 7-8)

Gr 6-8 Acknowledgement of Medication Policies for Overnight Trips
Gr 8 – Washington, D.C. - Fall 2019

Gr 7-8 STU Health Form for International Travel
Gr 8 –Mexico Mission Trip (if participating) – due October 2019

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)

×

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 (as needed)

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

Gr 7-10 and 12 only - Meningitis information form (required for all Gr 7-10 and all Gr 12)

Class Trips (Gr 9-12)

JTerm 2020 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: