Health Consent Form
I understand that in cases when my child has aggravating conditions, he or she will be referred to the Medical Doctor for further medical evaluation (usually at the Doctor’s private clinic and by appointment), or will be advised to consult a pediatrician for further assessment and evaluation. I have read and understood the School’s health protocols and will strictly comply with the above statements. I am aware of the risk of allowing my child to go and participate in any school programs and activities. My child’s participation in this school is entirely voluntary. I hereby release and waive United Christian Academy, its teachers, faculty members, staff, and other school personnel from any and all claims, demands, damages, rights of action, or causes of action, present or future, whether be known, anticipated or unanticipated, resulting from or arising out of participation of any school programs or activities.
The following are the stipulated health protocols as prescribed by the DepEd, IATF, and Department of Health together with the School:
Personal Health Profile
• To accomplish the health declaration form which shall be updated every Monday of the week and to be submitted to the school.
• To share my child’s personal information which may include my child’s name, home address, age, photos, and other information needed for my child’s health to persons as required by the law or on a need-to-know basis as determined by the school to promote my child’s best interests or protect your health, safety and security, and the like.
• To inform the school of any important changes to my child’s health, medication, or needs, including any changes to our home address and contact numbers. Scope of Responsibility The School Clinic
• To provide preventive services by educating teachers on the signs and symptoms of health problems of students and health screening.
• To provide infectious control such as daily cleaning, sanitation, and disinfection of the facilities.
• To provide health awareness programs using posters and seminars.
• To decline and instruct the child to go home when the child may compromise the health and safety of the school community.
• To administer medications in cases where it is prescribed by a physician due to my child’s health condition.
• To provide first aid as needed. Basic treatment, such as wound dressing, applying an ice pack or hot compress, and the like, is to be given to my child as the need arises provided that I will be notified as to my child’s health status. School’s Health Protocols
• In case of minor cases (minor wounds, scratches, minor injuries and etc.) These are health-related cases that do not require the child to go home or into the hospital.
o The teacher, faculty, and staff shall notify the School Clinic immediately.
o The School Clinic shall assess and apply first aid as needed.
o The School Clinic shall notify the parents/guardians about their child’s status.
• In case of moderate degree cases (fever, severe stomachache, and etc.) These are health-related cases that require the child to go home but not into the hospital.
o The teacher, faculty, and staff shall notify the school clinic.
o The School Clinic shall assess and apply first aid as needed.
o The School Clinic shall notify the parents/guardians immediately and request the parents to fetch their child from the school.
o In case the student is infected by a contagious or infectious disease, the child is mandated to home and be fetched by the parent/guardian.
• In case of emergency cases
These are health-related cases that require the child to go to the hospital.
• The teacher, faculty, and staff shall notify the School Clinic immediately.
• In the event of an emergency, I give them permission for medical treatment to be administered where considered necessary by the nominated first aider.
• The School shall contact me immediately and inform me about the status of my child. The School shall inform me which hospital my child will be brought.
• If I am not reachable at that moment and should require emergency hospital treatment, I am allowing the school to bring my child to the nearest hospital.
• The School Representative shall endorse my child to me or my child’s guardian that will arrive at the hospital.
• I shall pay hospital or treatment bills.
• I shall present a medical certificate that my child is ready to go to school again upon admission. Parents/Guardians
• To inform my child’s health and medical condition and to update them regularly.
• To check my child’s health status before he or she goes to school. In case there is a presence of any of the symptoms such as fever, chills, cough, colds, or other symptoms that indicates a low immune system, parents shall let their child stay and learn at home until fully recovered to prevent any further health complications.
• To acknowledge the risk of allowing my child to go and participate in any of the school programs and activities, such as acquiring infectious diseases, injuries, accidents, and any other health-related diseases and problems that may result in health complications and even death. Therefore, I shall decide whether I will allow my child to go and participate in any of the school programs and activities.
• To present an excuse letter upon admission. For some cases, such as being infected with a contagious or infectious disease and the like, the parent shall present a medical certificate that indicates the readiness of the child to go to school again.
I understand that in cases when my child has aggravating conditions, he or she will be referred to the Medical Doctor for further medical evaluation (usually at the Doctor’s private clinic and by appointment), or will be advised to consult a pediatrician for further assessment and evaluation. I have read and understood the School’s health protocols and will strictly comply with the above statements. I am aware of the risk of allowing my child to go and participate in any school programs and activities. My child’s participation in this school is entirely voluntary. I hereby release and waive United Christian Academy, its teachers, faculty members, staff, and other school personnel from any and all claims, demands, damages, rights of action, or causes of action, present or future, whether be known, anticipated or unanticipated, resulting from or arising out of participation of any school programs or activities.