Lexington High School Permission Form for Acetaminophen/Ibuprofen, LPS Health Screenings, Pet Therapy, and Hand Sanitizer
Dear Parent/Guardian,

Please complete each section of this form to give your child permission to receive acetaminophen/ibuprofen, participate in health care screenings and pet therapy sessions or opt-out of using hand sanitizer for the 2022-2023 School Year. This form must be completed by an adult/guardian and be received by Tuesday, September 6th.

Please complete a separate form for each one of your children.

Thank you, 
LPS School Nurses
Sign in to Google to save your progress. Learn more
Email *
Full Name of Parent/Guardian completing this form. *
Next
Clear form
Never submit passwords through Google Forms.
This form was created inside of Lexington Public Schools. Report Abuse
Google Forms