MEDICAL INFORMATION FOR BUS DRIVER

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

The Pine Grove Area School District is required to keep all health information regarding your child(ren) strictly confidential. Therefore, we cannot provide this information to your child(ren)’s bus driver.

If you want the bus driver to be aware of any health information (i.e. asthma, bee sting or food allergies) for your child(ren), please complete the information listed below and GIVE IT DIRECTLY TO THE BUS DRIVER by Friday, September 1, 2020.

Student Name *

Grade *

Bus No *

Health Information *

Check the box below * By checking this box and typing my name below, I am electronically signing this document. *

Yes

Parent/Guardian Name (First and Last Name) *

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of Pine Grove Area School District. Report Abuse

Forms