Forms:

For your convenience, PDF links to our school forms are available below. 

ALL OF THESE FORMS ARE REQUIRED TO BE COMPLETED for students attending St. Francis de Sales School for the Deaf in Brooklyn.

Change of Address or Emergency Contact Form
Cambio de Dirección ó Contacto de Emergencia

English – Spanish

Excuse for School Absence Form

English – Spanish

Consent to Administer Medications Form
Consentimiento para Administrar Medicamentos

English – Spanish

Student Device Loan Agreement Form

EnglishSpanish

 

Guidelines for All Health Forms & Medical Accommodations Forms 2022-2023

Guidelines for the Provisions of Health Services 2022 – 2023

English

Medical Accommodations Request Form 2022 – 2023

English

General Medication Administration Form 2022 – 2023

English 

Request for the Provision of Medically Prescribed Treatment (Non-Medication) 2022 – 2023

English 

Allergies/Anaphylaxis Medication Administration Form 2022 – 2023

English

Asthma Medication Administration Form 2022 – 2023

English 

Diabetes Medication Administration Form 2022 – 2023

English

Physical Form – 2022 -2023

English

Seizure Medication Administration Form 2022 – 2023

English

Authorization of Release of Health Information Pursuant to HIPAA

English

Eye Report and Recommendations

English

Click this link for the NYCDOE website for all forms in languages other than English:

https://www.schools.nyc.gov/school-life/health-and-wellness/health-services