Editing previous response:

Please fix the highlighted areas below before submitting.

Back to School Form (Student health Information) 2021-22

These forms are required to be completed prior to the first day of school along with a copy of the students most up to date immunization records.  This form must be filled out for every child in your household that attends RGS. 

Student's Grade*
Answer Required

Please list ANY medical conditions or doctor's restrictions concering your child, inlcuding but not limited to the following (please put N/A if any section is not applicable: 

Please note: All medication to be take at school must be administered by school staff.  A parent signed release fomr allowing school staff to admister medication to a student much be on file in the office.  This includes the use of inhalers, pain relievers, and over-the-counter medications.  The form is available through the RGS front office. 

Confirmation Email