The Kent Denver Emergency Health Form is an “interactive pdf form.” You can fill out the form on your own computer (using Adobe Reader) and then print the completed form on your home printer. The form will not print unless all highlighted fields in the parent portions of the form are completed. Please CLICK ON THIS LINK TO OPEN THE FORM and follow these instructions:
1. All highlighted fields must be filled in. If your answer is “none” (for example, if your child has had no surgical operations), you must type the word “none” in the space provided.
2. When you have completed the parent portions on pages 1 and 2, you should print the form using the PRINT FORM button in the upper right corner of page 1. (Do not use your File>Print button.)
3. Once you have printed the form, you must sign by hand on the signature lines on pages 1 and 2.
4. Deliver or mail the printed, signed form to your child’s doctor. After your doctor has completed the doctor portion, the form must be sent to Kent Denver.