Student Health Assessment

STUDENT HEALTH ASSESSMENT

STUDENT DETAILS:

Name:

Year/Grade:

Date of Birth:

Date:

Assessed By:

ASSESSMENT TYPE:

( ) Routine screening ( ) Health concern ( ) Return from illness

( ) Prep/Foundation entry ( ) Annual review ( ) Other: ___

PARENT/CARER CONSENT:

( ) Obtained ( ) On file ( ) Verbal consent

HEALTH HISTORY:

Known Conditions:

Current Medications:

Allergies:

Immunisation Status: ( ) Up to date ( ) Incomplete ( ) Unknown

ASSESSMENT FINDINGS:

Vision:

( ) Screened — Result:

( ) Not screened this visit

Hearing:

( ) Screened — Result:

( ) Not screened this visit

Height: ___ cm

Weight: ___ kg

BMI (if applicable):

General Health Observations:

[Appearance, hygiene, nutrition concerns, dental health, skin conditions]

Mental Health / Wellbeing Observations:

[Mood, anxiety, social concerns — flag only, refer for clinical assessment]

ACTIONS TAKEN:

( ) First aid provided

( ) Medication administered