Forms

Back to School Forms 2022-23

Please print and complete these required forms, and any optional forms needed, and email a scan or photo of them to Robyn Kolke. You may also bring them in-person to Robyn in the P3 office.

Back-to-School Required Forms:

Back-to-School Optional Forms:

Volunteer Background Check Must be on file in the P3 office to volunteer, along with a copy of your driver's license.     FERPA District Opt-Out Letter and Form - Parents who DO NOT want directory information or photographic images released must submit an Opt-out request in writing to their student's school office ANNUALLY - by September 15 each year. Print, complete, and return to Robyn

7th Grade Tdap Booster Documentation Required: 

The Tdap is a booster vaccine which continues to protect your child against the tetanus, diphtheria, and pertussis diseases they were immunized against as young children. As of August 1, 2020, in Washington State, a Tdap vaccine is required for students attending school in 7^th through 12^th grades.  (Please note that this booster is not the Dtap immunizations your student had to enter kindergarten.) 

Options to access and record your family's immunization information:

Vaccine documentation must be emailed to the SMS school nurse Shani Kapoor or bring it to Robyn in the P3 office. If we do not receive documentation, by law, we must send you a Notice of Exclusion for Immunization Noncompliance, RCW 28A.210.120.

OPTIONAL: Medication forms

• Confidential Emergency Health Information (CEHI) - Updates needed every year for our school nurse
• Student Insurance Letter - English - This letter includes details about student insurance available. Everyone must complete and return the second page
• Student Insurance Letter - Spanish
• Option 1: Log in to MyIR to view and download your family's immunization information
• Option 2: Visit your pharmacy, healthcare provider, or the Department of Health to request a complete immunization record 
• Option 3: Complete a Certificate of Immunization Status form
• Option 4: Complete a Certificate of Exemption form
• • If any medication is required at school (over-the-counter and prescription), the medication forms must be completed by a licensed healthcare provider and parent before the student can return to school. 
    • Please print, scan or take a picture, and email forms to the nurse:  SHANI KAPOOR and cc Robyn
      • For general medications:
        • Medication order form 
      • For Seizure care:
        • Emergency Seizure Medication Form
      • For Diabetic care:
        • Diabetic Physician Order Form
        • Diabetic w/Insulin Pump Physician Order Form