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Health Services Forms & Documentation

Please find all of the health forms and documents for the Springfield Platteview Community Schools.  Please notify us at the Director of Student Support Services office (402-594-0548) if you are unable to find the appropriate health form.

Folder Pre-school (2 Files)
pdf file Preschool Health Letter
pdf file Preschool Physical Form
Folder Kindergarten (3 Files)
pdf file Kindergarten Health Letter
pdf file Kindergarten Physical Form
pdf file Physical Exam/Visual Evaluation Waiver
Folder 7th Grade Physicals (1 Files)
pdf file 7th Grade Physical, Medical Waiver, & Insurance Form
Folder 8th Grade Sports Physicals (All four forms must be submitted!) (5 Files)
pdf file Physical Exam Form
pdf file Medical Release Form (PC)
pdf file Insurance Form
pdf file NSAA Consent Form
pdf file All Forms Combined
Folder High School Sports Physicals (All three forms must be submitted!) (4 Files)
pdf file High School Physical Form
pdf file Consent Form
pdf file High School Medical Release Form
pdf file High School Insurance Waiver
Folder Asthma-Allergy Action Plan (3 Files)
pdf file AOAN Action Plan
pdf file Medical Records Update Form
pdf file Self Management of Asthma and Severe Allergy
Folder Diabetes (1 Files)
pdf file Self-management at School
Folder Medications at School (3 Files)
pdf file Guidelines
pdf file Over-the-counter Drugs Permission Form
pdf file Prescription Drugs Permission form
Folder Outdoor Education (2 Files)
pdf file Outdoor Education Letter and Medication Form
pdf file Outdoor Education Permission for Medication
Folder Seizure Action Plan (1 Files)
pdf file Action Plan