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Whitehall Central School District

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Health Office

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  • Whitehall Central School Dist
  • Health-Related Forms
  • Health Certificate/Appraisal Form (Physical Examination)

    Health Certificate/Appraisal Form (Physical Examination)

    This form is used for physicals for new students, all grades, and for sports.
    NYS School Health Examination Form.pdf 261.79 KB (Last Modified on November 29, 2023)
    Comments (-1)
  • Athletic Health History

    Athletic Health History

    Use this form to provide a medical history of your child if he/she wishes to play sports (Physical Form).

    athletichealthhistory.pdf 93.51 KB (Last Modified on November 25, 2020)
    Comments (-1)
  • Self-Medication Release Forms

    Self-Medication Release Forms

    This form must be completed in addition to the routine district medication form for students who request permission to carry their own medication on campus or keep this medication in a P.E. locker.

    Self-Medication Release.pdf 48.94 KB (Last Modified on November 29, 2023)
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  • Medication Authorization Form

    Medication Authorization Form

    Per NYS Medication Procedures, this form is necessary in order to administer ANY medication during the school year!
    Please Note: This form must be filled out for both prescription and over-the-counter drugs.

    Permission to Administer Medication.pdf 42.21 KB (Last Modified on November 29, 2023)
    Comments (-1)

87 Buckley Rd

Whitehall, NY 12887

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P: (518) 499-1772

F: (518) 691-9284

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