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Student Forms

Please see forms below and complete any that are required for your daughter. Some may need to be downloaded and completed by a physician before being returned to the School Office at Oakland Catholic. Others, like the Medical Emergency Form, may be completed online.

Downloadable Forms

Form	Freshmen	Sophomores	Juniors	Seniors
Self Administration of Medication	Required	Required	Required	Required
Health Assessment	Required	-	-	-
Medical Emergency Form	Required	Required	Required	Required
Athletics Physical Form	Required for Athletes	Required for Athletes	Required for Athletes	Required for Athletes

*Once completed, please return forms to the School Office.

Online Forms

Student Vacation Request
Medical Emergency

Student Vacation Request

Vacation Request Form

Required

Parents must fill out this form at least two weeks prior to the start date of their vacation/extended absence. Once your vacation is approved by Administration, it is the responsibility of the student to notify all of her teachers when she will be out. Students are responsible for any missed work.

Submission Date*required

Must contain a date in M/D/YYYY format

Student's Grade*required

Student Name*required

First Name

Last Name

Parent Name*required

First Name

Last Name

Parent Email Address*required

Start Date of Vacation*required

Must contain a date in M/D/YYYY format

End Date of Vacation*required

Must contain a date in M/D/YYYY format

Number of School Days Missing*required

Reason for Vacation*required

Please include a reason for the student's vacation/extended absence.

Medical Emergency

Medical Emergency Form

Required

Please complete both pages of the form below and submit by July 28th. Be sure to provide current email addresses that are checked regularly.

Student Name*required

First Name

Last Name

DOB*required

Must contain a date in M/D/YYYY format

Grade*required

Please use the grade for next school year.

Father's Name

First Name

Last Name

Father's Email Address

Home Phone

Cell Phone

Mother's Name

First Name

Last Name

Mother's Email Address

Home Phone

Cell Phone

Guardian's Name*required

First Name

Last Name

Guardian's Email Address

Home Phone

Cell Phone

IN CASE OF AN EMERGENCY, WHO WOULD BE THE 1ST PERSON TO CONTACT?

Name*required

First Name

Last Name

Emergency Phone Number*required

Relationship to Student*required

If neither parent/guardian can be contacted, please list one relative or friend who would have the authority to advise us regarding your daughter.

Name*required

First Name

Last Name

Relationship to Student*required

Home Phone*required

Cell Phone*required

Name of your daughter's pediatrician*required

Pediatrician Phone*required

Hospital or Emergency Room Preference

Check any health condition(s) that your daughter may have

Asthma

Diabetes

Epilepsy

Allergies

Please list any other conditions

Food/Drug Allergies

Are allergies life-threatening requiring an Epi-Pen at school?

Yes

Please list ALL medications your daughter is currently taking

During the past year, has your daughter had any serious illness, injury, operation, or hospitalization?*required

Yes

If yes, indicate here

Does your daughter have any medical/mobility concerns of which we should be aware?*required

Yes

If yes, indicate here

Tylenol*requiredAcetaminophen

Yes

Acetaminophen

Antacid*requiredStomachache

Yes

Stomachache

Benadryl*requiredAllergy Medication

Yes

Allergy Medication

Ibuprofen*requiredAdvil/Motrin

Yes

Advil/Motrin

By typing my name below, I give my consent to the school nurse to administer medications indicated by the previous 4 responses.*required

Date*required

Must contain a date in M/D/YYYY format

Oakland Catholic High School

144 North Craig Street, Pittsburgh, PA 15213

P: 412.682.6633

F: 412.682.2496

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