Free Blank School Nurse Medical Report Letter Template
Blank School Nurse Medical Report Letter
[School Name]
[School Address]
[City, State, ZIP Code]
[Phone Number]
[Email Address]
Date: [Insert Date]
To Whom It May Concern:
This letter serves as a medical report for [Student's Full Name], a student at [School Name]. The student has been seen and treated at the school health office for the following condition(s):
Student Information:
-
Name: [Student's Full Name]
-
Date of Birth: [DOB]
-
Grade: [Grade Level]
-
Teacher/Class: [Class Name]
-
Parent/Guardian: [Parent/Guardian Name]
-
Emergency Contact Number: [Emergency Contact]
Reason for Visit:
[Describe symptoms or the reason for the student visiting the nurse’s office. For example, "Student reports headache and dizziness," or "Student was seen for a routine check-up."]
Medical Evaluation and Treatment Provided:
[Describe the evaluation conducted and any treatment given. For example, "Temperature taken and found to be 100.4°F. An ice pack was applied to the forehead. Student advised to rest."]
Further Action or Recommendations:
[If applicable, provide recommendations or actions required. For example, "Student advised to stay home for 24 hours," or "Recommended follow-up with a family doctor for further evaluation."]
Returning to Class:
The student [is/is not] fit to return to class today. If further medical attention is needed, please contact the school nurse.
Please feel free to contact the school health office at [phone number] if you require any additional information.
Thank you for your attention to this matter.
Sincerely,
[Your Name]
School Nurse
