The health and well-being of every student is a main priority for our school.  Therefore, Yeshivat He’Atid requires annual health forms for every child. The health forms provide permission for your child to participate in gym and all school activities.  All forms are due back by August 15th. Please scan and email forms to, or mail to 1500 Queen Anne Road Teaneck, NJ 07666 AFTER July 25th. No child will be allowed into school on the first day without the required forms. PLEASE DO NOT SUBMIT CAMP FORMS. All students must meet the state immunization requirements for their age/grade, or they will not be allowed to remain in school. We do not accept religious exemptions for vaccinations.

Required Forms:

1- Health History Form
This form should be completed by a parent and is required for all students attending school.

2- Please choose one of the following Options:

Health Record
To be used for Toddlers through Grade 5 (and Grades 6-8 if not playing on a sports team).  This form includes permission for administration of over the counter medications. This form is to be completed by the child’s pediatrician and signed by a parent. Annual flu shots are required for all Pre-K students and must be received before December 31st.


Preparticipation Physical Evaluation
Grades 6 through 8- If there is ANY chance that your child may participate on a sports team, this form must be filled out by you and your doctor in its entirety.  Otherwise, please complete Health Record.

Over-the-Counter Medication Form
This form needs to be signed by both a parent AND needs a doctor’s signature.  No medication will be given without this form completed in full.

Elective Forms:

Allergy Action Plan
If your child has any allergies that may require Benadryl, Epinephrine, or other allergy medication at school, you and your doctor must complete this form.  It is critical that we have this information so that medication is not delayed.

Asthma Treatment Plan
If your child has chronic or even occasional asthma, please complete the form WITH your doctor.  There must be BOTH a parent and a doctor’s signature.

Medication Administration Form
We encourage you to schedule all medication to be taken at home.  However, if your child may require any medication during school hours, whether over the counter or prescription, please complete this form with your doctor. All medication must be sent to school in original pharmacy bottle.

If you have any specific concerns regarding your child, please feel free to email me at

Rachel Aron RN
School Nurse