School Health Forms and Action Plans

Forms

• Public School Parents/Guardians enrolling their child in school: download and print the Commonwealth of Virginia School Entrance Health Form MCH 213G.
• Private/Parochial School Parents/Guardians, Head Start programs, Child care providers, local health departments, day or residential camps, or others: may also utilize the Commonwealth of Virginia School Entrance Health Form MCH 213G, download and make copies as needed.
• Foreign Language Commonwealth of Virginia School Entrance Health Form - MCH213G -
  •  Arabic, Dari, Chinese, Korean, Pashto, Russian, Spanish , Tagalog, Ukrainian
  • (Mancomunidad de Virginia Formulario de Salud Para El Ingreso Escolar)
• Health care providers: may also utilize the Commonwealth of Virginia School Entrance Health Form MCH 213G, download and make copies as needed.

• • Instructions to fill out form
  • Certificate of Religious Exemption

Action Plans and Toolkits

• VDH Guidelines for Healthcare Procedures in Schools
• VDOE School Health Services Website
• CDC Concussion Signs and Symptoms Tool Kit
• Epilepsy Foundation Information
• Epilepsy Seizure Action Plan
• Food Allergy.Org - FARE
• FARE Food and Allergy Emergency Action Plan
• ACAAI Allergy/Anaphylaxis Information
• Anaphylaxis Emergency Action Plan
• ACAAI Asthma Resource
• AAAAI Asthma Emergency Action Plan and Resources
• Virginia Asthma Coalition Asthma Action Plan
• Virginia Diabetes Council Resources
• Virginia Diabetes Council Tool Kit – DMMP and Forms