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Arlington Central School District

Health Forms

Physical Exam and Dental Forms

A physical examination is required for all students entering the Arlington School District and prior to grades K, 1, 3, 5, 7, 9 and 11. New York State requires a physical examination and dental exam for all students entering the Arlington School District and prior to grades K, 1, 3, 5, 7, 9 and 11.

NYS Health Exam Form

Dental Health Certificate

Medical Requirements Letter

Medical Requirements Letter pdf.pdf 173.03 KB (Last Modified on March 3, 2023)

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Medical Requirements Letter (Spanish)

Medical Requirements Parent Letter June 2022 Spanish.pdf 453.25 KB (Last Modified on June 10, 2022)

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Health History Form

13_Health History Form.pdf 475.03 KB (Last Modified on March 3, 2023)

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Emergency Health Information Summary

16_Emergency Health Information Summary.pdf 191.29 KB (Last Modified on March 3, 2023)

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BMI Parent Letter (Spanish)

1 BMI Parent Letter 2022-2023 SPANISH.pdf 263.72 KB (Last Modified on December 2, 2022)

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BMI Parent Letter

1 BMI Parent Letter 2022-2023.pdf 364.86 KB (Last Modified on December 2, 2022)

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NYS Immunization Requirements

18-19 Vaccination requirements.pdf 95.42 KB (Last Modified on August 6, 2018)

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Medications in Schools (Dispensed by Nurse or Self-Administered)

If medical conditions require a child to receive medication during school hours, a physician must provide a written statement.

Scroll down below to find the medication order form for your school.

Medications in School letter 2022-2023.pdf 449.21 KB (Last Modified on July 8, 2022)

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Tdap and Varicella 6th Grade Requirement

1 Tdap parent letter August 2022.pdf 403.69 KB (Last Modified on August 8, 2022)

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Meningoccal Vaccine Requirement 2022

Meningococcal Vaccine School Requirement Parent Letter August 2022 AHS LMS UVMS.pdf 538.73 KB (Last Modified on August 8, 2022)

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Students with Life Threatening Conditions

Students-with-Severe-Life-Threatening-Conditions.pdf 92.546 KB (Last Modified on June 8, 2018)

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Abrasions, Cuts or Puncture Wounds

Guidance for treating scrapes, cuts, and punctures and for looking for signs of infection

Abrasions_Cuts or Puncture Wounds.pdf 114.93 KB (Last Modified on August 6, 2018)

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End of Year Medication Pick-Up Information

Medications-end-of-year-pick-up-parent-letter.pdf 426.749 KB (Last Modified on June 8, 2018)

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Medication Order Forms (Please locate applicable school)

Arthur S. May School

Medication Order Form ASM.pdf 127.01 KB (Last Modified on June 22, 2021)

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Beekman Elementary School

Medication Order Form BES.pdf 124.87 KB (Last Modified on June 22, 2021)

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Joseph D'Aquanni West Road Intermediate School

Medication Order Form WEST.pdf 209.89 KB (Last Modified on June 22, 2021)

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Noxon Road Elementary School

Medication Order Form NOXON.pdf 126.94 KB (Last Modified on June 22, 2021)

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Overlook Primary School

Medication Order Form OPS.pdf 127.33 KB (Last Modified on June 22, 2021)

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Titusville Intermediate School

Medication Order Form TIS.pdf 126.31 KB (Last Modified on June 22, 2021)

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Traver Road Primary School

Medication Order Form TRAVER.pdf 125.57 KB (Last Modified on June 22, 2021)

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Vail Farm Elementary School

Medication Order Form VFES.pdf 125.67 KB (Last Modified on June 22, 2021)

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LaGrange Middle School

Medication Order Form LMS.pdf 124.63 KB (Last Modified on June 22, 2021)

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Union Vale Middle School

Medication Order Form UVMS.pdf 123.49 KB (Last Modified on November 7, 2022)

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