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Dear Parent or Guardian, In an effort to better address the health needs of students, the State of Tennessee requires that throughout the 2008-2009 school year, the Hamblen County school system must screen all students in the K, 2, 4, 6, 8, and 9th grades. Trained school nurses and health care personnel will complete all screenings with strict adherence to confidentiality of each child and adolescent screened. Please note there will be no charge for these services. The screenings will include:
Kellie C. Smith, M.P. H. School Health Coordinator 423-587-5316 ksmith@hcboe.net
PLEASE PRINT THE ABOVE ATTACHED ORIGINAL SCHOOL SCREENING CONSENT FORM (DO NOT PRINT THIS WEB PAGE). I DO NOT want my child to participate in the following screenings (please check all that apply):
___Height ___Weight ___Blood Pressure ___Vision ___Hearing
Child’s Name: ____________________________________________________ Parent or Guardian’s signature: _______________________________________ Date: ___________________________________________________________ |