School Health Resources/Forms
- Orders for Student with Diabetes and Information for HCP Development (.pdf)
- Kansas Asthma Action Plan (.pdf)
- School Nurse Contract Letter
- School Nurse Sample Contract
- ACIP Recommended Childhood Immunization Schedule
- Sports Physical Forms
- CLIA User Fee Schedule (.pdf)
- Certification of Health Form for School Personnel (.pdf)
- Certificate of Waiver Tests (.pdf)
- Kansas Certificate of Immunization (KCI) (.pdf)
- Kansas Certificate of Immunizations - Form B Medical Exemption (.pdf)
- KBH/Child Health Assessment for (option for School Entry or Day Care) (.pdf)
- CLIA (Clinical Laboratory Improvement Amendments) Regulations relating to schools (.pdf)
- Mandatory Blood Lead Screening Questionaire - 6 mos & 72 mos. (.pdf)
For further information, contact:
School Health Consultant = (785) 296-1300
Kansas Department of Health & Environment