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Hornell City School District
Nurse's Office Forms
Nurse's Office Forms
Nurse's Office Forms
Phone extensions for the nurse offices are as follows:
North Hornell- 324- 0014 ext.- 1743
Bryant - 324-2171 ext- 1204
Intermediate - 324-1304 ext- 1103
High School - 324-1303 ext- 1586 & 1587
Authorization for Use or Disclosure of Protected Health Information
FormPermissionDiscloseProHealthInfo.pdf
116.2 KB
(Last Modified on April 3, 2020)
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Health Examination Form
Health Examination Form.pdf
146.74 KB
(Last Modified on August 17, 2020)
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Health Services Guidelines
Health Services 2020.pdf
186.31 KB
(Last Modified on April 3, 2020)
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Permission to Administer Medication
To Physicians and Parents of Children requiring Medication in School.pdf
104.52 KB
(Last Modified on Tuesday at 8:43 AM)
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