Forms

WRSD Health Forms - Printable Versions

Student Health 

• Student Enrollment Information
• Physical Form
• Health History Form
• Massachusetts School Immunization Requirements 2025/2026
• Immunization Exemption Religious/Medical Letter 
• Physical Exam Requirements

Medication 

• Medication Order Form - To be completed with each medication that will be given at school.
• Self Administration Form - To be completed in collaboration with the School Nurse
• Diabetes School Supply List

Action Plans

• Asthma Action Plan
• Bee Allergy Action Plan
• Latex Allergy Action Plan
• Food Allergy Action Plan
• Seizure Action Plan

Health Screening

• Health Screening Opt-Out form
• SBIRT Opt-Out form

Other Forms

 

• Extracurricular Activity Registration Form
• Epi-Pen Emergency Authorization School Transportation Form
• Meal Modification Form - Medical Statement for Students who require special meals at school.