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Northeastern School District

100% of our students will graduate and be fully prepared for post-secondary education

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Forms/Medical Paperwork

  • DISTRICT MEDICAL FORMS
  • Northeastern School District
  • DISTRICT MEDICAL FORMS
  • Asthma Checklist

    Asthma Checklist

    Checklist for students with asthma
    Asthma Checklist.pdf 417.69 KB (Last Modified on June 4, 2018)
    Comments (-1)
  • Dental Examination Form

    Dental Examination Form

    Private dental examination paperwork
    Dental Examination Form.pdf 18.94 KB (Last Modified on June 4, 2018)
    Comments (-1)
  • Diabetic Checklist

    Diabetic Checklist

    Checklist for students with diabetes 
    Diabetic Checklist.pdf 417.54 KB (Last Modified on June 4, 2018)
    Comments (-1)
  • Diet Order

    Diet Order

    Medical Statement for Students with Special Dietary Needs
    NESD diet order.pdf 156.08 KB (Last Modified on June 4, 2018)
    Comments (-1)
  • Information about Potassium Iodide (K-1)

    Information about Potassium Iodide (K-1)

    Learn more about Potassium Iodide (K-1)
    Information about Potassium Iodide - KI.pdf 212.91 KB (Last Modified on June 4, 2018)
    Comments (-1)
  • Insect Sting Allergy checklist

    Insect Sting Allergy checklist

    Checklist for students with allergic reactions to insect stings/bites
    Insect Sting Allergy Checklist.doc.pdf 251.53 KB (Last Modified on June 4, 2018)
    Comments (-1)
  • Medication during school policy

    Medication during school policy

    Students requiring medication during school must complete this form.
    medication policy 2020.pdf 297.64 KB (Last Modified on September 9, 2020)
    Comments (-1)
  • Please Complete - Medication during school hours

    Please Complete - Medication during school hours

    Medication During School Hours Form.pdf 59.43 KB (Last Modified on July 17, 2019)
    Comments (-1)
  • Physical Examination Form

    Physical Examination Form

    Required physical examination form
    Physical Examination Form.pdf 266.77 KB (Last Modified on June 4, 2018)
    Comments (-1)
  • School Vaccination Information (English)

    School Vaccination Information (English)

    Learn more about what vaccinations are required.
    2017 School Vaccination Information for Parents.pdf 2.16 MB (Last Modified on June 4, 2018)
    Comments (-1)
  • School Vaccination Information (Spanish)

    School Vaccination Information (Spanish)

    Obtenga más información sobre qué vacunas se requieren
    2017 School Vaccination Information for Parents Spanish.pdf 2.1 MB (Last Modified on June 4, 2018)
    Comments (-1)
  • Seizure Checklist

    Seizure Checklist

    Checklist for students who have seizure disorders
    Seizure Checklist.pdf 391.6 KB (Last Modified on June 4, 2018)
    Comments (-1)

NESD, 41 Harding Street, , Manchester, PA 17345

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It is the policy of Northeastern School District not to discriminate on the basis of race, color, national origin, sex, employment practices, as required by Title IX of the Education Amendments of 1972, Section 504 of the Rehabilitation Act of 1973, and Title VI of the Civil Rights Act of 1964.
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