Contact

"Healthy Children Are Better Learners"
 
Sharon Wade, Supervisor
 
Office
(531) 299-9671
Fax
(531) 299-0395

Exam Information

The Nebraska State School Law, in part, requires that each student have a physical examination and a vision examination within six months prior to entrance into school, or upon transfer into the school district from a district outside of the state. A physical exam is also required for seventh grade, without the vision exam requirement. The vision exam form is included on the physical exam form, and may be completed by a health care provider or an optometrist.

A complete dental check-up is strongly encouraged at this time also.

If you do not wish to provide evidence of a physical exam and/or a vision exam, a signed statement waiving this requirement must be submitted to the school by November 1 (or 60 days after enrollment). Please note, if your child will be participating in competitive athletics, a physical examination by a licensed health provider is required and signing a waiver does not satisfy this requirement.

Physical Education Restrictions/Exemptions

Middle or high school students who have restrictions for participation in PE must have a health care provider's order on file, delineating what the restrictions are. Students who cannot participate because of health related concerns must have a health care provider's note on file exempting them from the class.

FormDescription of FormLink
Health Exam Card, Preparticipation History, Athletic Insurance, NSAA/OPS Consent, Head Injury/Concussion Acknowledgement and Fact SheetHistory Form to be completed/signed by student before the physical with review and sign-off by parent/guardian for possible future athletic participation. Health care provider completes Health Exam Card and reviews History Form. Insurance, Consent, Head Injury/Concussion forms completed by student and parent/guardian for athletic participation in an after-school sport. View
Tarjeta de Examen de Salud, Historial de pre participación, Seguro atlético, Consentimiento NSAA/OPS, Hoja de Información y Reconocimiento de Conmoción/lesión CerebralEl formulario del historial debe ser completado/firmado por el estudiante antes del físico con la revisión y firma del padre para posible participación deportiva en un futuro. El proveedor del cuidado de salud completa la tarjeta de salud y revisa el formulario del historial. Seguro, consentimiento, formulario de Conmoción/ lesión Cerebral completado por el estudiante y padre para la participación en un deporte después de la escuela. View
FormDescription of FormLink
Preparticipation History, Physical Exam, Athletic Insurance, NSAA/OPS Consent, Head Injury/Concussion Acknowledgement, Fact Sheet History Form to be completed/signed by student with review and sign-off by parent before athletic participation examination. Health care provider completes Physical Exam Form and reviews History Form. Insurance, Consent and Head Injury/Concussion forms completed by student and parent/guardian. This is completed for participation in after-school sports for grades 8 thru 12.View
Historial de pre participación, Examen Físico, Seguro atlético, Consentimiento NSAA/OPS, Hoja de Información y Reconocimiento de Conmoción/lesión Cerebral.El formulario del historial debe ser completado/firmado por el estudiante con la revisión y firma del padre antes de participar en el examen deportivo. El proveedor del cuidado de salud completa el formulario del Examen Físico y revisa el formulario del historial. Seguro, consentimiento, formulario de Conmoción/ lesión Cerebral completado por el estudiante y padre para la participación en un deporte después de la escuela para los grados 8 al 12. View
FormDescription of FormLink
Physical Examination CardEntrance to school or out of state transfersView
Tarjeta de Examen FísicoEntrada a la escuela o transferencias de fuera del estadoView
School Vision Evaluation Report FormEntrance to school or out of state transfersView
Forma de Reporte de Evaluación de la Vista Entrada a la escuela o transferencias de fuera del estadoView