Medical Information Form 2022-2023

Required form, one per student. Due 8/1/22.
  • EMERGENCY CONTACTS

  • To be contacted in the event of an emergency, if parent/guardian cannot be reached.
  • To be contacted in the event of an emergency, if parent/guardian cannot be reached.
  • Medical History

  • Buxton School Over-the-Counter Medications/ Annual Influenza Vaccination

    Buxton School hosts an on-campus flu shot clinic annually (generally in late September or early October). Students are encouraged to sign up to receive the flu shot on campus if they have not yet received their annual flu shot. Parental permission is required for students under 18.
  • CURRENT HEALTH INSURANCE INFORMATION

  • Max. file size: 300 MB.
    Please upload images/copies of your student's health insurance card - front & back. Thank you!
  • Max. file size: 300 MB.
    If your student's prescription insurance is different than their medical insurance, please include photos of the front & back of the prescription insurance card.
  • This field is for validation purposes and should be left unchanged.

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