Health Services Forms & Links

Exam form to be completed by physician

Vision Exam form for 4K/5K (recommended but not required).

Guidelines: 

• Medication Form: All medications must have a completed school medication form.
• Over-the-Counter (OTC) Medications: Only the parent signature is required.
• Prescription Medications: Both the parent and physician portions of the form must be completed.
• Dosage Guidelines: All OTC medications (including herbal supplements) must be FDA approved and follow recommended usage. If a dosage exceeds the recommended amount, the physician portion of the form must also be completed.
• Original Container Required: Prescription, OTC, and herbal medications must be in their original container or bottle.
• Transportation of Medications: Parents are responsible for delivering and picking up medications. Exceptions may apply for insulin, EpiPens, and inhalers, depending on physician authorization. At the end of the school year, all remaining medications must be picked up by a parent.

(6th-12th grade)

Over-the-Counter (OTC) Medications: Only the parent signature is required. 

Must be completed by the 30th day of school.

Seymour School District has partnered with Tri-City Dental to give our students access to free dental care for those who cannot afford it. The dental bus comes to campus and spends the day helping kids in need of dental services!

Medication Consent Form

Immunization Form

Permission to give meds form (6-12 grado)

Immunization updates