Online Student Application

  • Health Form

    Please fill out the form correctly.
  • Student Information

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  •   Name(s) Relationship to Student Phone Numbers
    1
    2
  • Health History

  • Additional Information

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  • Authorization

  •   Yes No
    1. Minor first aid by nurse at the school clinic (medication & treatment)
    2. Emergency care at the school clinic
    3. Transportation to a hospital of the school's choosing, in severe or emergency cases
  • NOTE: If you selected "NO" to numbers 1,2, and 3, the clinic will not provide any health care for the student, until alternate emergency care instructions (from parents or official guardian) areon file with the clinic.

  • Please note: Brent International School NURSES will provide care for any minor medical problem/s which may occur during the school day.

  • Other Requirements

  • If your doctor makes any recommendations or restrictions during the school year regarding your child's health, please submit the recommendation or certificate to the school as soon as possible. Otherwise, your child will be considered "PHYSICALLY FIT" and able to participate in Physical Education (P.E.) activities required by the curriculum and in other activities that may be part of the school program.

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This page was last updated on Mon, 11/26/2012 (3:50pm)