If you need any support completing the questionnaire or have any questions please contact us on 020 3317 4460.

Required
My child is in: Required
Required
Required
Required
Required
Required
Required
Required
Required
What is your preferred method of contact? Required
Does your family speak English? Required
Do you require an interpreter?
Required
Is your child registered with a dentist? Required

Health information

Does your child have any allergies? Required
If yes, do they require an Adrenaline Auto Injector (Epi-Pen/Jext/Emerade)? Required

Please note: If your child does carry an Adrenaline Auto Injector (Epi-Pen/Jext/Emerade) for allergy, the school must be provided with two. 

If you are having issues with obtaining these from you GP or local pharmacy, please let the school and our service know and we can try support you with this.
Does your child have a long-term health condition? Please tick in the box(es) that apply Required
If you have ticked the above, have you informed the school of your child’s health needs?
Does your child attend any hospital appointment or clinics, including CAMHS? Required
Does your child take any regular medications? Required
Will your child need to take any regular medications during school? Required

Please make sure the school is provided with any medication needed.

Will your child need to have emergency medication in school? For example, inhalers for asthma, insulin for diabetes or medications for seizures Required

Please make sure the school is provided with any medication needed.

Do you have any concerns about your child’s health including mental health? Required
Do you have any concerns about your child’s eating habits or weight? Required
Does your child have any concerns with wetting and/or soiling? This includes night wetting Required
Do you have any concerns about your child’s speech or other development? Required
If you have had previous worries or concerns have these been discussed with a health visitor Required
Do you have a social worker for the family? Required

Why this is important

Good health and wellbeing is essential for your child to develop and fulfil their potential.  We work together with children’s services to help support your family with all your child’s needs.

Immunisations Record

Please ensure your child’s immunisations are up to date. You can do this by checking in your red book or with your doctor’s surgery.  Please provide immunisation details below or, alternatively, send us a copy of your child’s immunisations records.

It is important that your child has had two MMR injections.  If you are unsure please see your practice nurse or GP for more information. 

For more information on why we give vaccinations and their safety please visit https://www.nhs.uk/conditions/vaccinations/

School health review - FOR PRIMARY SCHOOL CHILDREN ONLY

The School Health Review take place in school by the School Nurse or the School Health Technician. 

The School Health Review includes: (please tick the correct box, if you consent or decline for your child to have the following)

This section is for parents of primary school children only. If your child is in secondary school, please skip this section.

I consent for my child to have their Height & Weight measurement taken
Your child will receive a vision check in school, with your consent. They should also receive a sight check annually by an optician which is provided free of charge until the age of 16 years.
Your child should have had a new born hearing test. Your child will receive a follow up hearing check in school
Required
Required
Required
Required
Do you have parental responsibility? Required
Required