Medical Information

Requested by

Caller Details

First Name

Last Name

Phone

Street Number

Street Name

Town

School

Grade

Student Last Name

Student First Name

Student ID

Medical notes to add to student file

Please include any relevant information that may be required in case of an emergency i.e. Epipen, IWK reference number, equipment on hand, seizure protocol. Note: Bus drivers and monitors are not permitted to administer medications to students.

Submitted by I acknowledge that the information provided will be shared with the HRCE Student Transportation Team and bus service provider. This information will be also be shared with your student's bus driver and/or monitor as required. Acknowledgement Required

Last Name

First Name

In accordance with the Personal Information Protection and Electronic Documents Act, personal information requested in this form will assist in providing transportation services. The information is gathered in accordance with the Education Act and FOIPOP Act.

Medical Information

Caller Details

More than one student matches the criteria submitted. Please select the student to use

Medical notes to add to student file

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