BSM Medical Information Form
This form plays a vital role in maintaining accurate and up-to-date health records for your child. The information you provide will enable us to ensure the well-being and safety of your child.

Your collaboration in completing this form, in a timely manner, will help us comprehensively understand your child's health needs, allergies, medications, and any other relevant health-related information. Accurate health records enable us to respond promptly and effectively to any health concerns or emergencies that may arise while your child is at school.

All information provided will be treated with utmost confidentiality and will only be accessed by authorised school personnel involved in your child's well-being and safety.

Please take a few moments to complete this form accurately and thoroughly. Your attention to detail ensures that we have the most current and accurate information about your child's health, enabling us to provide the best possible care and support.

Thank you for your collaboration and dedication to your child's well-being. If you have any questions or need assistance completing the form feel free to reach out.

Kind regards,
The Health Centre Team


Sign in to Google to save your progress. Learn more
Email *
Purpose of Completion *
Student's First Name *
Student's Last Name *
Student's Date of Birth *
MM
/
DD
/
YYYY
Medical Conditions *
Please let us know if your child has any of the following medical conditions. 
If they have a medical condition that is not in this list, please select 'other' and provide us with details in the next question.
Required
If any options are selected above, please provide further information (including medications required)
Does your child take any regular medications?

 *
If so, please provide details (name, reason, dose and frequency)
Has your child required hospital treatment/investigations within the last 2 years? *
If yes, please provide further information
Does your child have any medical / mental health condition that may impact their learning? *
Emergency Contacts
Parent Emergency Contact 1 Name *
Parent Emergency Contact 1 Number
 *
Parent Emergency Contact 2 Name
 *
Parent Emergency Contact 2 Number
 *
First Aid Consent / In case of an emergency
 *
I hereby give permission to qualified health personnel (school nurse; outside emergency medical personnel; staff who possess a current first aid certificate) to:
  • Administer non-prescription, over the counter medication (analgesia; throat lozenges; topical/oral antihistamine)
  • Administer first aid
  • To escalate the care for my child and transfer them to a hospital of the school's choice (if transfer to hospital is deemed necessary). BSM's Health Centre reserves the right to decide on the most appropriate hospital.
  • I accept that any costs associated with my child’s transfer to and treatment in hospital will be borne by myself the parent / guardian
Changes to Medical Information *
I commit to informing the school Health Centre of any changes in my child's health status, medical conditions, allergies, medications, or other relevant health-related information.

I understand that timely and accurate health updates are crucial for the safety, well-being, and appropriate care of my child during their time at the school.

I agree to notify the School Health Centre of any changes in my child's health and provide necessary documentation and updates promptly.
Name of person completing form
 *
This should be a parent or guardian of the student
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
PrivacyTerms
This form was created inside of British School Muscat. Report Abuse
Google Forms