Harrisburg Academy

Medical Forms Checklist

Electronic Forms

- This symbol denotes that this form should be completed online. The link will take you to the online version of this form.

Medical Forms Checklist 2011-12
*Last updated April 29, 2011

Online

HATS

JK

K

1st

2nd

3rd

4th

5th

6th

7th

8th

9th

10th

11th

12th

Returning Students

Emergency Medical Info Form

X

X

X

X

X

X

X

X

X

X

X

X

X

X

X

Physical Required (download form)

X

X

X

X

Dental Exam Required (download form)

X

X

X

New Students - From PA

Emergency Medical Info Form

X

X

X

X

X

X

X

X

X

X

X

X

X

X

X

Physical Required (download form)

X

X

X

X*

X*

X*

X*

X*

X

X*

X*

X*

X*

X

X*

Former School Medical Records

X

X

X

X

X

X

X

X

X

X

X

X

Immunization Records

X

X

X

X

X

X

X

X

X

X

X

X

X

X

X

Dental Exam Required (download form)

X

X*

X*

X

X*

X*

X*

X

X*

X*

X*

X*

X*

New Students - From Out of State

Emergency Medical Info Form

X

X

X

X

X

X

X

X

X

X

X

X

X

X

X

Physical Required (download form)

X

X

X

X

X

X

X

X

X

X

X

X

X

X

X

Former School Medical Records

X

X

X

X

X

X

X

X

X

X

X

X

X

X

X

Immunization Records

X

X

X

X

X

X

X

X

X

X

X

X

X

X

X

Dental Exam Required (download form)

X

X

X

X

X

X

X

X

X

X

X

X

X

MedicationPermissionForm necessary as needed.

X*= Only necessary if Former Medical Records are unavailable

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