Health Services Forms
Please mail the following forms to Hathaway Brown School, 19600 N. Park Boulevard, Shaker Heights, OH 44122, ATTN: Jody Duecker.
The full time Registered Nurse, Judy Wilson, can be reached Monday through Friday, during regular school hours, at 216-320-8092.
Physical Examinations - Due July 15
Physical Examination Form
Immunization Requirement for Students Entering 7th Grade
Medical, Religious, or Philosophical Exemption Form
Seizure Action Plan
Screenings - Please contact the school nurse at 216-320-8092 if you need a replacement copy of the following nurse-issued forms:
Vision Screening Referral Report
Ohio Department of Health, Eye Specialist Report
Hearing Screening Referral Report
Postural Screening Referral and Medical Report