Health Services

HEALTH OFFICE FORMS

SPORTS PHYSICALS
Sports Physical

PA Physical Exam Form
Health History Form
Physician and Parent Request for Admin of Meds at School
Family Dentist Report
Bee Sting Information Form
Asthma Information Form
Self-carry Asthma Inhaler Form
Seizure Information Form
Food Allergy Action Plan

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Current Pennsylvania Vaccinations Requirements

Lincoln Jr/Sr High School Nurse
Nancy Berezniak
724.752.1591 ext. 3036
nberezniak@ellwood.k12.pa.us

Hartman Nurse
Shelby Beck
724.752.1591 ext. 2911
sbeck@ellwood.k12.pa.us

Perry Nurse
Charlene Lucarelli
724.752.1591 ext. 1911
clucarelli@ellwood.k12.pa.us

North Side Nurse
Jenna Valentino
724.752.1591 ext. 4911
jvalentino@ellwood.k12.pa.us

Where to get help:

PA Department of Health
http://www.health.state.pa.us

Free or reduced cost immunizations
Lawrence County Health Department
724.656.3088

Information on Health Insurance
1.800.822.CHIP
http://chip.aetna.com