Medical Forms

Up Panther Web District Panther E-Mail Site Map Feedback

    

 

 

  Located here are various forms that the Nurse or Athletic Director may need filled out from time to time. These forms are all in Adobe Acrobat Reader (pdf) format.

You will need to have Adobe Acrobat Reader (ver 6 or higher) installed to utilize these forms. Go here for versions for Windows 98, ME, XP & 2000

General Forms

Dental Form (238K) - 1 page

School Physical (711K) - 2 pages

Various Medication Forms

Private Physician Request for Administration of Prescription & Non-Prescription Medication during School Hours for the School Year - 1 page

Self-Administration by Student Only for Inhalers & Epi-Pens - 1 page

Sports Forms

PIAA - Comrehensive Initial Pre-Participation Physical Evaluation (CIPPE)
Posted May 2007

All-Sports
Sections 1-4

(2.7M)

Elementary Wrestling
Sections 1-4

(2.5M)

Re-Certification by Parent\Guardian & Authorized Medical Examiner
Sections 5-6

(957K)

 

All materials posted on this site are the property of
Commodore Perry School District unless otherwise posted.
Copyright ©1955-2012 -

Panther Web Home