**As of February 2021, your child's doctor MUST submit his/her exam on the New York State School Health Examination Form or an electronic equivalent.

To be completed by parent or guardian. Please list your all of your child's health conditions and current medications. If your child has severe allergies and/or anaphylaxis, please contact the school nurse to ensure that she is aware at 518-297-7211 ext. 5411.

For completion by your child's dentist

For completion by a New York State licensed health care provider.