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Health Forms

Required Student Health Forms

As we prepare for the upcoming 2019-20 school year, we need to receive certain information from you to provide appropriate health care for your child(ren) when necessary and to comply with state law and regulations. Please refer to the checklist below in order to complete and submit all of the necessary forms for your child(ren).

Forms are available for download on this page and should be completed and returned to Linda Christensen in the Middle School nurse’s office or mailed to: Holland Hall, 5666 East 81st Street, Tulsa, OK, 74137.

Forms are due by July 31, 2019. If our health files are not complete, your child(ren) will not be able to participate in athletic practices or attend school in August 2019.

Please fill out all forms in ink!


Emergency & Student Health Info Form »


Physical Examination Form »


Medical History Form »


Authorization for Prescription Medication/Inhaler Form »


Sudden Cardiac Arrest Info & Form »


Concussion & Head Injury Awareness & Management Form »


OSSAA Eligibility Form »


Health Form Checklist

GradeEmergency & Student Health Info FormPhysical Examination FormMedical History FormAuthorization for Prescription Medication/Inhaler Form*Sudden Cardiac Arrest Info & FormConcussion & Head Injury Awareness & Management FormOSSAA Eligibility Form
EPKYESNONOYESNONONO
PKYESNONOYESNONONO
JKYESNONOYESNONONO
KYESYESNOYESNONONO
1YESIF NEWNOYESNONONO
2YESIF NEWNOYESNONONO
3YESIF NEWNOYESNONONO
4YESYESNOYESNONONO
5YESYESNOYESNONONO
6YESYESYESYESNONONO
7YESYESYESYESYESYESYES
8YESYESYESYESYESYESYES
9YESYESYESYESYESYESYES
10YESYESYESYESYESYESYES
11YESYESYESYESYESYESYES
12YESYESYESYESYESYESYES

* The Authorization for Prescription Medication/Inhaler Form is needed ONLY if your child will take PRESCRIPTION medication or use an INHALER at school.

Download Health Form Checklist »


Post-Concussion Return-to-Learn Protocol

Holland Hall recognizes the need to develop researched based practices to support students who have experienced concussive events and are managing a return to full activity. As new research surfaces, we continue to better understand the diagnosis and treatment of concussions. Please take a moment to familiarize yourself with our Post-Concussion Return-to-Learn Protocol.

Read the Post-Concussion Return-to-Learn Protocol »