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Health Forms

New Hartford Public Schools Health Forms

If the form you need is not listed below, please call the Health Office of the school your child attends. 


Authorization for the Administration of Medication by School Personnel 


Food Allergy Action Plan 


Health Assessment Record (please print on blue paper) 


Medical Statement for Children with Disabilities  
(meal substitutions for children with disabilities)


Medical Statement for Children without Disabilities 
(meal substitutions for nondisabled children with special dietary needs) 


Permission To Treat  (online form)

Student Medical Information (online form)

School Nurses

Kara Albee

New Hartford Elementary
School: 860-379-0713
School Fax: 860-379-6762

Christine Holland

Antolini School
School: 860-489-4169
School Fax: 860-489-0392

Marie Kitch

Bakerville School
School: 860-482-0288
School Fax: 860-482-1905