I order in this pharmacy is not the first time. As and range of drugs. There are rare medicines that are hard to find in other pharmacies. How to delivery fast kamagra australia Thank you for your good work.All is as it should be.
Medical form 2011-12
2011 - 2012
PLEASE PRINT. Form must be returned by July 1. Student may not attend class if form is not on file.
THE FOLLOWING INFORMATION MUST BE COMPLETED AND SIGNED BY THE STUDENT’S PARENT/GUARDIAN.
(for non-emergencies only)
Significant health condition
and/or chronic illnesses
(e.g., asthma, diabetes, seizures) *
(food, insects, medications, etc.)
Prescription and non-prescription medications
taken regularly or frequently at home (must be listed) *
∗ IMPORTANT: Please contact the school nurse the week before the first day of school if your daughter has a significant health
condition and/or chronic illness listed above, or if she needs emergency medicine (e.g., Epi-Pen, Glucagon, asthma inhaler) at school. The nurse may be reached at 269-1238.
the school may administer (must check al that apply – no medications wil be given unless indicated on this form)
Topical analgesic (Benadryl cream, gel
Dental anesthetic gel (Orajel
First aid antibiotic cream (Neosporin
(for allergic reactions)
Please cal parent/guardian before giving medications.
MEDICAL EMERGENCY RELEASE
In the event that any il ness or injury occurs, and it is not possible to contact me, my designated contact persons, or my designated physician, I authorize the Academy of the Sacred Heart to obtain emergency medical, surgical, or dental treatment for my daughter.
Parent/Guardian’s name (Please print.)
MEDICAL INFORMATION RELEASE
In order to best meet the education and developmental needs of your daughter, it is important that her faculty know about any medical
condition that she may experience and any medications prescribed for her.
I authorize the school nurse to inform the administration, faculty, and staff of my daughter’s health condition and/or medicines
I do not authorize the release of information about my daughter’s health.
Parent/Guardian’s name (Please print.)
MEDICAL EVALUATION AND IMMUNIZATION RECORD
THE FOLLOWING INFORMATION MUST BE COMPLETED AND SIGNED BY THE STUDENT’S PHYSICIAN OR
PHYSICIAN’S OFFICE. THIS INFORMATION WILL BE TREATED IN A CONFIDENTIAL MANNER.
To be completed for students entering ASH-FIN, Little Hearts, PK, grades 1, 5, 9, and for all new students.
Date of last examination
(must be within the last six months)
(Please mark with a if satisfactory or an X if not satisfactory.)
Date last given
This student may participate
in the fol owing
Exceptions / special problems / dietary restrictions / recurring abnormalities /
prescribed medications / allergies
To be completed for students entering ASH-FIN, Little Hearts, PK, K, grades 1-9, and for all new students.
Month, day, and year dose was given
Date of next immunization
I certify that this child has received the above noted immunizations and is in compliance with rules set forth by the state of Louisiana, Department of Health and Hospitals, Office of Public Health.
Physician’s signature x
Academy of the Sacred Heart
JAMES THOMAS SUMMERSGILL, Ph.D. PROFESSOR OF MEDICINE Address: Department of Medicine University of Louisville Louisville, Kentucky 40292 USA (40202 for Express Courier) Telephone: 502-852-5132 Facsimile: 502-852-1512 E-Mail: firstname.lastname@example.org Born : August 17, 1951 Montgomery, Alabama, USA United States Citizen Education : Ph.D. 1988 University of Louisville,
Indy komt is in 1999 uit Spanje gekomen. Toen ik haar kreeg was er wel het een en ander mis met haar gezondheid. Ze kwam bij ons toen ze ongeveer 5 of 7 jaar was. Haar leeftijd was moeilijk te schatten omdat heer tandjes heel slecht waren. We hadden haar een paar dagen toen ze het ineens heel benauwd kreeg. Een echte astma aanval, dus direct met haar naar de dierenarts. Daar kreeg ze Predni