Dear Caregiver:

In order to service our students and clients, we require that current medical and contact information about your child be available in our files. By ‘clicking’ on the appropriate links you will:

Ø      Be able to open and print the Special Alerts, Emergency Contacts & Student Information Form on your printer, complete the information area and mail the document to us. Use the mailing address listed in the heading of the Medical Form. Please mark the envelope to the attention of Ms. J. Zymaris.

Ø      Please do not fax the information to us because of the confidential nature of the information therein enclosed.

Ø     The Special Alerts, Emergency Contacts & Student Information Form may be completed on line. However, since the document requires an original signature, it must be printed, signed, dated and sent to us via the US Post Office.

Ø      Hints for the completion of the interactive Special Alerts, Emergency Contacts & Student Information Form.

o       Move from field to field using the ‘TAB’ key

o       Telephone number format automatically. Therefore, enter only the ten digits, without parenthesis or dashes.

o       Save your completed form with a new name, so that you can maintain a copy of the form on your computer.

We respect your privacy and take every measure necessary to protect it.