Kentucky Department of Education

 

School Health Forms

Last Updated on Wednesday, December 03, 2008 at 10:01 PM

 

School Health Forms and Administrative Regulation 704 KAR 4:020 (updated 2008) 704 KAR 4:020 has been updated with changes to the medical examination for school employees.These forms may also be found in the Health Services Reference Guide (HSRG). 

The following are the most requested school health forms.

Kentucky School Eye Exam Form School Eye Exam Form

Immunization Certificate

KY Immunization Certificate

Immunizations Medical Exemption Certificate

Medical Exemption Certificate

Immunizations Religious Exemption Certificate

Religious Exemption Certificate

Student Exam Form: PreK-Grade 4

Preventative Health Care Exam K-4

Student Exam Form: 6-12

Preventative Health Care Exam 6-12

KHSAA Sports Physical Form (2008)

0408 KHSAA Sports Physical Form l.pdf

Pupils Cumulative Health Record

Pupils Cumulative Health Record

Medical Examination of School Employees (2008)

704 KAR 4:020 School Health Services

 

 

KDE Employee Exam Form 2008 .pdf

School Health Services Reference Guide

HSRG_2008_REV

 

For more information contact:

Karen Erwin
2545 Lawrenceburg Road
Frankfort, KY 40601
Phone: (502) 564-5625
Karen.Erwin@education.ky.gov