All forms must be submitted by Friday, June 14, 2019.

Department of Health regulations require that a child not start Summer Camp or the school year if all forms have not been returned.  Medical forms are required every year on the anniversary of your child’s last visit to the doctor. If the current form is still within a year, please save this form until it is needed.

 Children will not be allowed to attend school if medical and immunizations are not current.

If any of these forms do not apply to your child, please write N/A and your child’s name on the form. 

If you have any questions, please contact Jane Liescheidt at or at 212-721-8888 – ext. 126.


Please download and complete these forms. You may sign them electronically and submit them online, or print them out and return them. Please note that to sign the forms electronically you will need to SAVE each form on your computer and open it in Adobe Acrobat before filling it out and pressing the “Submit This Form” button.

Tylenol Form
Emergency Information Form 
Contact Form for Dismissal (in the event of an emergency)
Student Identification Form (new families only)
Class Trip Permission Form
Media Permission Form
Medication Form
Allergy Form
Diversity Form (new students only)
Coordination of Services Form
Materials Fee Letter


Please download and print/forward these forms to your physician to be completed, signed and returned.

Annual Medical Examination form including Immunizations Medication Form
Dental Examination Form