SSS Health Summary

    Student Information

    Name(Required)
    MM slash DD slash YYYY
    Permanent Address(Required)
    Parent 1 / Guardian Name(Required)
    Parent 1 / Guardian Address(Required)
    Parent 2 / Guardian Name(Required)
    Parent 2 / Guardian Address(Required)

    Health Summary

    Student's Health Summary 1 (Choose ALL)(Required)
    Please choose all that apply to your health condition.
    If you choose any from the Student's Health Summary 1, please explain the details.
    Did you get vaccinated for Covid?(Required)

    Max. file size: 52 MB.

    Emergency Contacts

    Emergency Contact 1 (Name)(Required)
    Address
    Emergency Contact 2 (Name)(Required)
    Address

    Insurance Information

    Completion of this section is voluntary. However, should the need for medical attention occur, this information would be very helpful.
    MM slash DD slash YYYY