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Student Medical Record

The school Health Centre requests health information of your child through this form. Please fill in the necessary information. 

This will serve as the child’s record in the clinic. If you have any question, you can contact our school at +65 6524 0500.

1. CHILD'S LEARNING NEEDS

Has your child/ward ever had (Please submit all pertaining documents)

2. HEALTH

Does the student have any problems with the following?
Does the student have any problems with the following?

Emergency Treatment Authorization: In the event of emergency when immediate observation or treatment is deemed necessary in the judgement of the school nurse and authorities, I authorize and direct the school authorities to send my child to the medical facility most readily accessible.

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Parent/Guardian Information

First Name *
Last Name *
Relationship to Child *
Email *
Phone Country Code *
Phone No. *

Student Information

Gender *
First Name *
Last Name *
Birthday *
Citizenship *
Singapore Identity *
Name of Current School *
Current Grade *
Child’s hobbies *
English Level *
Apply for admission grade *
Visiting Date *
Visiting hours
How did you hear about us? *

Parent/Guardian Information

First Name *
Last Name *
Email *
Phone Country Code *
Phone No. *
How did you hear about us?
When will you be contacted?
Programs *
Privacy Policy *

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