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Plainville Community School District

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(860) 793-3200
(860) 747-6790
1 Central Square, Plainville, CT 06062
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Health Forms
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Health Forms
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Plainville Community School District » Departments » Health Services » Health Forms
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To select and print, please click on one of the following:

Health Assessment Record K-12

Health Assessment Record Preschool

Authorization for Medication Administration

Authorization for the Transfer/Release of Medical Records

Authorization for Treatment Procedure

EpiPen Administration Form.pdf

Authorization for Administration of Asthma Medication.pdf



If the form that you are looking for is not listed, please contact your child's school nurse.



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Plainville Community School District

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  • Plainville Community School District

    1 Central Square

    Plainville, CT 06062

  • Plainville High School

    47 Robert Holcomb Way

    Plainville, CT 06062

  • Middle School of Plainville

    150 Northwest Drive

    Plainville, CT 06062

  • Linden Street School

    69 Linden Street

    Plainville, CT 06062

  • Louis Toffolon Elementary School

    145 Northwest Drive

    Plainville, CT 06062

  • Frank T. Wheeler Elementary School

    15 Cleveland Memorial Drive

    Plainville, CT 06062

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