- Pine Valley Central School
- District Health Office Forms
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Dental Health Certificate
Dental Health Certificates are requested for grades: school entry, K, 2, 4, 7, & 10 but not required.
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HIPPA Release Form
HIPAA is a release of Health Information from the Primary Physician to the School
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Independent Medication Use and Carry
This form may be used as an addendum to a medication order which does not contain the required diagnosis and attestation for a student to independently use and carry their medication as required by NYS law. A provider order and parent/guardian permission is needed in order for a student to carry and use medications that require rapid administration to prevent negative health outcomes.
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Medication Form
The Medication Form is needed to be filled out by a student's primary doctor in order for students to have medication while at School/ School sponsored Events
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Directions For Health Exam Form
Instructions for Completion of New York State School Health Examination Form
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Yearly Health Updates
This is a yearly health information update for the school to inform the school of any current health concerns or immunizations for you child.