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Consent Forms and Authorization to Release Information

• Authorization to Release Confidential Information (MS Word File)
• Mental Health/Counseling Services Consent (MS Word File) Chinese, Spanish (pdf)
• Oath of Confidentiality (MS Word File)
• Screening and Assessment Section of Release Form (MS Word File)

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ExCEL After School Programs

For forms related to ExCEL After School Programs click here.

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Foster Youth Services (FYS)

• FYS Tutor Info Letter and Request Form (MS Word File)
• FYSL Intake Forms (MS Word File)
• FYSL Foster Care Monthly Activity Log (MS Word File)

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Health Advocate

• Health Advocate Administrative Directive (WAD) (pdf)
• Elementary Checklist Tracking Forms
  • Spring 2008 (MS Word File)

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Health Education

We educate kids and families about physical and emotional health. Our health education programs help young people develop knowledge, attitudes, behaviors and skills to maintain good health, prevent disease and reduce risky behaviors.

• Curriculum (MS Word File)
• Policies (MS Word File)
• Coordinated Program Monitoring Tool (CPM) (MS Word Files)
  • Teacher Verification Form
    Elementary, Middle School, High School
  • CPM Tally Sheet
    Elementary, Middle School, High School

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Health Promotion Committee (MS Word Files)

• LGBTQ Support Liaison Job Description
• TYOC Job Description
• YOC Job Description
• YOW Application & Registration
• AYOC Job Description
• HPC WAD
• YOW Job Description
• HPC Application
• HLC Job Description

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Healthy School Team (MS Word Files)

• PAPA Job Description
• Health Liaison Job Description
• LGBTQ Support Liaison Job Description
• Site Agenda Meeting Notes
• HST Application
• Weekly Administrative Directive
• Support Liaison Activity Log

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Learning Support Professional (LSP) and Nurse Log

• Please visit the LSP and Nurse Monthly Log Website
• LSP and Nurse Daily Log 2007-08.zip

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Notification Letters (pdf)

• Elementary School Parent Notification Letters
  English,Spanish, Chinese, Tagalog, Vietnamese, Russian
• Middle School Parent Notification Letters
  English, Spanish, Chinese, Tagalog, Vietnamese, Russian
• High School Parent Notification Letters
  
  
  • SFUSD Condom Availability Programs
    English, Chinese, Spanish
• Health Education Notification Letters
  English, Chinese, Spanish

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Nutrition Education Program

For forms related to Nutrition Education Program click here.

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School Nursing Forms

• Care plan flow chart (pdf)
• Consent Form (pdf)
• Emergency Card Care Plan & Parent Letter (pdf)
  English, Chinese, Russian, Spanish, Tagalog, Vietnamese
• Emergency Care Plans
  Generic: English, Chinese, Spanish (pdf)
  Allergy: English, Chinese, Spanish (pdf)
  Asthma: English, Chinese, Spanish (pdf)
  Diabetic: English, Chinese, Spanish (pdf)
  Seizure: English, Chinese, Spanish (pdf)
• Head Lice
  Guidelines for Parents to Control Head Lice:  English, Chinese, Spanish (pdf)
  Parent Notification Letter:  English, Chinese, Spanish (pdf)
  Proof of Treatment Letter:  English, Chinese, Spanish (pdf)
  Head lice decision chart (pdf)
• Medication Form
  English, Chinese, Spanish (pdf)
• Medical Condition List (MS Excel file)
• Referral Form (MS Word file)
• Student Emergency-Medical Information Card (pdf)
  English, Chinese, Spanish
• Student Emergency-Medical Information Card Processing Procedure (pdf)
• SFUSD School Health Form (pdf)
• SFUSD Athletics Preparticipation Physical Examination Form (pdf)

 

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SHPD Employee Forms (MS Word Files)

• Certificated Timesheet
• Classified Timesheet - Daily Time Report (Itinerant Staff)
• Classified Timesheet (Central Staff)
• Time Off Request
• Mileage/Expense Report
• Request for Reimbursement (.xls)
• Request for Purchase
• Request for Funding Source (K Resos, Stipends, Subs)

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Student Assistance Program

• What is a SAP? (pdf)
• SAP Action Plan (doc)
• SAP Best Practices Checklist (pdf)
• SAP Case Management Followup Form (doc)
• SAP Flowchart (pdf)
• SAP Meeting Agenda 1 (doc)
• SAP Meeting Agenda 2 (doc)
• Parent Teacher Conference Form (doc)
  
  

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Student Success Team (pdf)

• Completing the SST Log
• Menu Of Interventions 11-01
• SFUSD Language Survey
• SFUSD Student Referal for Assessment
• SFUSD Student Referral for Assessment - Chinese
• Speech and Language Checklist
• SST Best Practices
• SST Brochure - Chinese
• SST Brochure - English
• SST Brochure - Russian
• SST Brochure - Spanish
• SST Brochure - Tagalog
• SST Classroom Form
• SST Developmental History - Chinese (4.0)
• SST Developmental History - English (4.0)
• SST Developmental History - Spanish (4.0)
• SST Developmental History - Tagalog (4.0)
• SST Developmental History - Chinese (4.0)
• SST Facilitator Self-Assesment Checklist
• SST First Meeting Summary Form (2.0)
• SST Flowchart
• SST Log (5.0)
• SST Manual
• SST Observation of Learning Environment (3.0)
• SST Request for Assistance - Elementary (1.0)
• SST Summary Form for Follow-up Meetings (2.0a)
• SST Teacher Input - Secondary (2.1)
• Teacher Preparation Checklist for SST Meeting

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