School Based Health

 

School-Based Health centers are conveniently located in schools or on school campuses. Our eight school-based health centers see students, parents, teachers and community members for primary care. School-Based Health helps keep kids healthier and in school. Download the enrollment form for your student today:

HIPAA compliant School Based Health Enrollment Packet

Counseling Referral Form

Mental Health Patient History Form

COVID-19 Testing Consent Form

COVID-19 Vaccine Consent Form

HPV Vaccine Consent Form

TDAP Vaccine Consent Form

Meningococcal Vaccine Consent Form

Hepatitis A Vaccine Consent Form

Hepatitis B Vaccine Consent Form

Flu Vaccine Consent Form

MMR Vaccine Consent Form

Polio Vaccine Consent Form

Varicella Vaccine Consent Form

Sports Physical Form (Print Only)

Health Educator Survey

Our School-Based Health Sites:

Coal City Elementary

Fayetteville PK-8

Independence Middle School

Independence High School

New River Elementary

Oak Hill High School

Summersville Wellness Center

Valley Wellness Center

Or if you prefer the PDF form:  Enrollment Form

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