Health Appraisal Form printable pdf download

Health Appraisal Form

Commack Union Free School District

Hubbs Administrative Center

Clay Pitts Road

East Northport, New York 11731

Telephone: (631) 912-2028

Amy Ryan

Mailing Address:

Assistant Superintendent for Pupil Personnel Services

P.O.Box 150

Commack, NY 11725

Dear Parents/Guardians:

New York State Law requires that each school age child have a physical

examination upon their first entrance into school and in the second, fourth, seventh

and tenth grades. The physical examination form, attached to this letter, should be

completed by your family physician and returned by your child to the school he or

she attends in September.

If this form is not returned to school by the end of the first week in October, the

examination will be done by the physician’s assistant or our school physician. We

urge you to take your child to your family physician for an early and complete

medical examination.

The Commack Schools share with you an interest in your child’s health. It is clear

to all of us that the physical well being of students is an important factor in their

progress and success in school.

Sincerely yours,

Amy Ryan

Health Appraisal Form