School Health Forms

Health Services/Section 504 Accommodations

The Office of School Health manages the processes surrounding students needing medication administration, medically-prescribed treatment, glucose monitoring, insulin pump maintenance, and other Section 504 and Individualized Education Program (IEP) services.

Several health forms are used in the New York City public schools.Using these forms helps assure that children get the care, services, and accommodations they need during the school day.

The following forms can be downloaded, completed by parent/guardian and physician/health care provider, and submitted to the child's school.(Forms must be printed and completed by hand, not on-line.)

Educational Advocates (English)

About Us Academics Choices & Enrollment Facilities Offices & Programs Office of School Health Rules & Policies Student Support, Safety, and Activities Student Performance & Accountability	School Health Forms E-mail to a friend Health Services/Section 504 Accommodations The Office of School Health manages the processes surrounding students needing medication administration, medically-prescribed treatment, glucose monitoring, insulin pump maintenance, and other Section 504 and Individualized Education Program (IEP) services. Several health forms are used in the New York City public schools.Using these forms helps assure that children get the care, services, and accommodations they need during the school day. The following forms can be downloaded, completed by parent/guardian and physician/health care provider, and submitted to the child's school.(Forms must be printed and completed by hand, not on-line.) Guidelines for the Provision of Health Services and/or Section 504 Accommodations for Students for the 2008-2009 School Year This document is also available in Arabic \| Bengali \| Chinese \| Hatian Creole \| Korean \| Russian \| Spanish \| Urdu 1) Medication Administration Form (MAF) including Parent/Guardian's Consent, Authorization and Release for the School-Year 2008-2009 This form is also available in Arabic \| Bengali \| Chinese \| Hatian Creole \| Korean \| Russian \| Spanish \| Urdu 2) Request for Provision of Medically Prescribed Treatment(Non-Medication) Form 2008-2009 This form is also available in Arabic \| Bengali \| Chinese \| Hatian Creole \| Korean \| Russian \| Spanish \| Urdu 3) School Diabetes Management Form 2008-2009 Monitoring Blood Sugar, Medication and Dietary Needs: Parent/ Guardian's Consent, Authorization and Release 2008-2009 This form is also available in Arabic \| Bengali \| Chinese \| Hatian Creole \| Korean \| Russian \| Spanish \| Urdu 4) Request for Accommodations Under Section 504 of the Rehabilitation Act of 1973 for 2008-2009 This form is also available in Arabic \| Bengali \| Chinese \| Haitian Creole \| Korean \| Russian \| Spanish \| Urdu Parent Letter Attachment A--Renewal This letter is also available in Arabic \| Bengali \| Chinese \| Haitian Creole \| Korean \| Russian \| Spanish \| Urdu Parent Letter Attachment B --new students This letter is also available in Arabic \| Bengali \| Chinese \| Haitian Creole \| Korean \| Russian \| Spanish \| Urdu Policy Statement This statement is also available in Arabic \| Bengali \| Chinese \| Haitian Creole \| Korean \| Russian \| Spanish \| Urdu Educational Advocates (English)