PHS Choral Department Health Form
Plainfield Choral Department
1 Red Pride Drive
Plainfield, IN 46168

Michael Hummel, Director (317-839-7711 x1149)

Dear Parents/Students:

In an effort to better ensure the health and safety of our students, we are requiring this Medical Health Form to be completed and signed. This will cover your student for the 2022/2023 school year.

The information contained in this form is confidential.

Permission for obtaining medical care will only be used for emergencies or serious illness. Parents will be contacted as soon as possible.

Thank you for your cooperation in this matter.
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