Health Forms

Additional Fact Sheets and some forms are available in Spanish. Contact your school Health Clinic or Health Services at the Educational Service Center (918) 746-6364 / 65
UNIVERSAL POISON CONTROL 1 800 222-1222

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Parents' Flu Guide
Three Steps to Avoid the Flu (CDC)
Three Steps to Avoid the Flu - SPANISH (CDC)
Meningococcal Disease

Free Immunization Flier Information
Pediculosis (head-lice) Protocol
SoonerCare Application in English www.okhca.org/client/forms/pdflib/sc1.pdf
SoonerCare Application in Spanish www.okhca.org/client/forms/pdflib/sc1_sp.pdf

Health Services Forms for Parents
Form Form Name
HD1 Immunization Requirements for School Admission
HD1 Spanish Immunization Requirements for School Admission
HD1C Questionnaire- Immunization Contraindications
HD1D Hepatitis Information Letter
HD1I Hepatitis B Letter to Parents
HD17 Authorization for the Administration of Medication by Designated School Personnel
HD17B Medication Reminders
HD2 Facts About Your School Health Clinic
HD24 Health History
HD24 Spanish Health History
HD27 Care of the Feet
HD38 Request to Designate an Adult to Transport Medication/Medical Equipment
HD38 Spanish Request to Designate an Adult to Transport Medication/Medical Equipment
HD38A1 Request for Medication Supply Exemption
HD38A1 Spanish Request for Medication Supply Exemption
HD38B Letter - "... child/sibling bringing medication/medical equipment"
HD38B Spanish Letter - "... child/sibling bringing medication/medical equipment"
HD38C Student Ambulance Transport - Authorization to Treat and Transport
HD38C Spanish Student Ambulance Transport - Authorization to Treat and Transport
HD38C1 Employee Ambulance Transport - Authorization to Treat and Transport
HD38C1 Spanish Employee Ambulance Transport - Authorization to Treat and Transport
HD38D Emergency Instructions - Injectable Medications
HD38F Health Assessment Database: Asthma
HD38F Spanish Health Assessment Database: Asthma
HD38H Health Assessment Database: Diabetes
HD38H Spanish Health Assessment Database: Diabetes
HD41 Diabetic Information
HD41 Spanish Diabetic Information
HD47 Request for Treatment During School Hours
HD47 Spanish Request for Treatment During School Hours
HD51 Daily Hygiene Assistance
HD51 Spanish Daily Hygiene Assistance
HD53 Healthy Living
HD55B Request for Student Exemption from HIV/AIDS Instruction
HD55B Spanish Request for Student Exemption from HIV/AIDS Instruction
HD57 Field Trip Permission Form (multi)
HD57 Spanish Field Trip Permission Form
HD57A Field Trip Permission Form (single)
HD57A Spanish Field Trip Permission Form (single)

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