Report of Health Examination for School Entry

This form needs to be completed by a doctor and turned in to the school office when your first grader returns to school in August. It is a mandatory requirement for all first grade students to have this completed form on file.

You may return it by mail (4005 N. Sutter St. 95204), fax (209-466-1150), email ( or you can bring it to the school office. Our summer office hours are Monday - Thursday, 8 am - 3 pm and a mail slot is available for afterhours drop.