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Clinic Forms Upload
If you have not already done so, please visit our clinic forms webpage to download, print, and complete any necessary forms. Forms may then be scanned or clearly photographed and uploaded.
https://jeffersonacademysecondary.jeffcopublicschools.org/family_resources/docs/clinic
Student First name
*
Student Last name
*
Parent/Guardian Email (for confirmation)
*
Immunizations
If you need to submit immunizations, please upload files here.
Medications Agreement
To submit a Medications Agreement, upload it here:
Asthma Care Plan
To submit an Asthma Care Plan, upload it here:
Self carry medication contract
To submit an self carry medication contract, upload it here:
Diabetic Care Paperwork
To submit diabetic care paperwork, upload files here:
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