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Union Township Schools

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      • Union Township Schools
      • Middle School Health and Sports Physical Forms

      Health

      • Welcome
      • Elementary School Health Forms
      • Elementary School
      • Middle School
      • Middle School Health and Sports Physical Forms
      • Can My Child Go to School?
      • Health and Sports Policies Fall 2022

        Health and Sports Policies Fall 2022

        Health and Sports Policies Fall 2022.docx 24.08 KB (Last Modified on April 29, 2022)
        Comments (-1)
      • Middle School Medical Information- Start Here!

        Middle School Medical Information- Start Here!

        Middle_School_Medical_Information.pdf 68.49 KB (Last Modified on August 27, 2019)
        Comments (-1)
      • Sports Physical Form **Vision screening required as part of exam

        Sports Physical Form **Vision screening required as part of exam

        Pre-Participation Athletic Physical forms updated 2015.pdf 192.22 KB (Last Modified on October 24, 2017)
        Comments (-1)
      • Health History Update / Parent to complete (for physical exam more than 90 days prior)

        Health History Update / Parent to complete (for physical exam more than 90 days prior)

        PPE HEALTH HISTORY Update Questionnaire.pdf 44.42 KB (Last Modified on March 18, 2015)
        Comments (-1)
      • Sports Participation Parent Permission Form

        Sports Participation Parent Permission Form

        This permission form should be submitted with the sports physical, and again for each subsequent sport the student wishes to participate in.

        Sports Permission Form.pdf 52.13 KB (Last Modified on September 11, 2015)
        Comments (-1)
      • Concussion- Required Parent reading

        Concussion- Required Parent reading

        CDC Concussion Fact sheet for parents.pdf 351.31 KB (Last Modified on March 23, 2021)
        Comments (-1)
      • Opioid Use and Misuse/ Required Parent/Guardian Reading

        Opioid Use and Misuse/ Required Parent/Guardian Reading

        Fact Sheet on Opioid use and Misuse.pdf 3.74 MB (Last Modified on January 22, 2018)
        Comments (-1)
      • Sudden Cardiac Death in the Young Athlete- Required Parent/Guardian Reading

        Sudden Cardiac Death in the Young Athlete- Required Parent/Guardian Reading

        A pamphlet discussing sudden Cardiac Death in the young athlete must be read by the parent/guardian of every prospective student athlete, and a signature page returned to document this.
        cardiac.pdf 3.93 MB (Last Modified on August 14, 2014)
        Comments (-1)
      • Student Athlete and Parent signoff sheet for Concussion, SCD and Opioids

        Student Athlete and Parent signoff sheet for Concussion, SCD and Opioids

        Student Athlete and Parent Guardian signoff sheet.docx 16.38 KB (Last Modified on March 23, 2021)
        Comments (-1)
      • Student-Athlete Safety Act Parent Info Sheet

        Student-Athlete Safety Act Parent Info Sheet

        All physicians, APN's or PA's that complete the Pre-Participation Health Exam (Sports Physical) must have completed the new Student-Athlete Cardiac Assessment professional development module, and this must be noted on the appropriate place on the physical form.

        Student_Athlete_Safety_Act_Parent_Info_Fact_Sheet.pdf 112.95 KB (Last Modified on August 27, 2019)
        Comments (-1)
      • Sports Related Eye Injuries- Parent Fact Sheet

        Sports Related Eye Injuries- Parent Fact Sheet

         Information sheet on prevention and management of common eye injuries associated with sports in school aged children.
        SportsRelatedEyeInjury.pdf 1.07 MB (Last Modified on May 14, 2015)
        Comments (-1)
      • Asthma Action Plan *(Required for all Asthmatic Sports Participants)

        Asthma Action Plan *(Required for all Asthmatic Sports Participants)

        Asthma Action Plan.pdf 220.95 KB (Last Modified on June 8, 2018)
        Comments (-1)
      • Epinephrine Autoinjector Packet

        Epinephrine Autoinjector Packet

        This packet contains a letter from the school physician as well as necessary forms for self administration/nurse administration of an Epinephrine Auto-injector for anaphylaxsis.

        EPINEPHRINE_Packet_updated_2014.pdf 123.92 KB (Last Modified on August 27, 2019)
        Comments (-1)
      • Sixth Grade Entry-Required Immunizations

        Sixth Grade Entry-Required Immunizations

        Grade_Six_Required_Immunizations__parent_letter_2019.pdf 185.06 KB (Last Modified on August 27, 2019)
        Comments (-1)
      • School Nurse Authorization for Prescription and OTC Medication

        School Nurse Authorization for Prescription and OTC Medication

        SCHOOL NURSE AUTH FOR ADMIN OF MEDS v042012.pdf 82.78 KB (Last Modified on September 6, 2019)
        Comments (-1)
      • Over the Counter Medication in School

        Over the Counter Medication in School

        otc 2019.pdf 72.95 KB (Last Modified on August 23, 2019)
        Comments (-1)
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