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Clayton Intermediate School

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  • Clayton Intermediate School
  • CIS - Student Health Forms

Health Resources

Page Navigation

  • CIS Health Resources Home
  • CIS - Student Health Forms

State Student Health Forms

  • Delaware Department of Education Tuberculosis Risk Assessment Questionnaire for Students
  • Prevention & Emergency Response Plan for Students with Allergies
  • Delaware Student Health Form – Children, PreK-Grade 6
  • Delaware Student Health Form – Adolescent, Grades 7 – 12
  • DIAA Sports Physical Form (Spanish)
  • DIAA Sports Physical Form
  • Student Health History Form
  • Smyrna High School Wellness Center Consent Form

District Student Health Forms

  • DELAWARE STUDENT HEALTH FORM – ADOLESCENT Grades 7-12  (SPANISH Version)

    DELAWARE STUDENT HEALTH FORM – ADOLESCENT Grades 7-12 (SPANISH Version)

    DE Health Form SPanish.pdf 220.36 KB (Last Modified on February 4, 2025)
    Comments (-1)
  • Parental Request to Have Prescription Medication/Treatment Administered in School

    Parental Request to Have Prescription Medication/Treatment Administered in School

    Medication Administration Sheet.pdf 397.23 KB (Last Modified on July 21, 2020)
    Comments (-1)
  • Student Possession and Use of Asthmatic Quick Relief Inhaler Release Form

    Student Possession and Use of Asthmatic Quick Relief Inhaler Release Form

    inhaler release form.pdf 129.4 KB (Last Modified on July 21, 2020)
    Comments (-1)
  • Student Possession and Use of Auto-Injectable Epinephrine Release Form

    Student Possession and Use of Auto-Injectable Epinephrine Release Form

    auto injectable.pdf 105.46 KB (Last Modified on July 21, 2020)
    Comments (-1)

Address

86 Sorrento Drive, Clayton, DE 19938

Phone

(302) 653-4512

Fax

(302) 653-3271

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The Smyrna School District does not discriminate in employment, educational programs, services or activities based on race, color, marital status, creed, religion, national origin, gender, age, genetic information, sexual orientation, gender identity, disability or any other protected category or status in accordance with state and federal laws. Inquiries should be directed to the District Superintendent. 82 Monrovia Ave, Smyrna, Delaware 19977, or telephone (302) 653-8585
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