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  • KAWIT ES Go Home Slip

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    EMETERIO FLORESCA
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    This document contains forms from Kawit Elementary School in the Philippines related to student health. The May Go Home Slip certifies that a student was treated at the school clinic and can be released to a parent/guardian. It includes reminders to monitor symptoms and instructions from the doctor. The Referral Slip refers a student to an outside agency for further care and treatment. It requests medical findings and recommendations to be returned to the school. The document provides forms for schools to document student medical issues, treatment, and coordination of care between schools and external health services.

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    This document contains forms from Kawit Elementary School in the Philippines related to student health. The May Go Home Slip certifies that a student was treated at the school clinic and can be released to a parent/guardian. It includes reminders to monitor symptoms and instructions from the doctor. The Referral Slip refers a student to an outside agency for further care and treatment. It requests medical findings and recommendations to be returned to the school. The document provides forms for schools to document student medical issues, treatment, and coordination of care between schools and external health services.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
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    Download as docx, pdf, or txt
    22 views3 pages

    KAWIT ES Go Home Slip

    Uploaded by

    EMETERIO FLORESCA
    This document contains forms from Kawit Elementary School in the Philippines related to student health. The May Go Home Slip certifies that a student was treated at the school clinic and can be released to a parent/guardian. It includes reminders to monitor symptoms and instructions from the doctor. The Referral Slip refers a student to an outside agency for further care and treatment. It requests medical findings and recommendations to be returned to the school. The document provides forms for schools to document student medical issues, treatment, and coordination of care between schools and external health services.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as docx, pdf, or txt
    of 3

    Republic of the Philippines

    Department of Education
    REGION XII
    SCHOOLS DIVISION OF SOUTH COTABATO
    POLOMOLOK 4 DISTRICT
    Polo, Polomolok, South Cotabato
    KAWIT ELEMENTARY SCHOOL

    MAY GO HOME SLIP


    Date: ________________________
    Name: ____________________________________________
    Age: _____________
    Sex: _____________
    Grade/Section: ________________________________
    Teacher/Adviser: __________________________________

    This certifies that the learner has been provided initial management at the clinic, with instructions
    from from:
    ___________________________________________
    Name of Doctor

    The doctor has given instruction that the learner may go home/be fetched by his/her
    parent/guardian.

    Signed: ______________________________________
    Clinic Teacher/Nurse

    This certifies that I have been provided important information/instructions by the Clinic
    Teacher/Nurse.

    Signed:________________________________
    Name of Teacher: _________________________________
    Relation to the Child: _____________________________
    Time Fetched: ____________________________________

    Present this May Go Home Slip and cut and leave the upper portion of the slip to the guard before leaving the school.
    ----------------------------------------------------------------------------------------------------------------------------
    This lower portion may be brought home by the parent/fetcher.

    REMINDERS TO THE PARENT:

    Please monitor the following:


    ____ Fever ____ Diarrhea ____ Body pains
    ____ Cough and Colds ____ Fatigue/Tiredness
    ____ Difficulty of breathing ____Headache
    ____ Soar Throat ____Loss of taste/smell

    Please consult with ____________________________


    Your child has been reported to the BHERT, (____________________):please coordinate with them for the next steps.
    Please inform the school immediately if your child tests positive for COVID-19.
    Medical certificate/clearance is required before the learner is allowed to return face-to-face classes, subject to the approval of
    the DepEd Medical Officer.

    Other Instructions: ___________________________________________________________________________________


    ___________________________________________________________________________________

    Kawit Elementary School


    Purok Maligo, Polomolok, South Cotabato
    School ID: 130725
    Facebook Page: DepEd Tayo Kawit ES
    Republic of the Philippines
    Department of Education
    REGION XII
    SCHOOLS DIVISION OF SOUTH COTABATO
    POLOMOLOK 4 DISTRICT
    Polo, Polomolok, South Cotabato
    KAWIT ELEMENTARY SCHOOL

    REFERRAL SLIP

    To: _________________________________________ Date: ______________________________


    (Agency)
    Address: _______________________________________________________________________________

    This is to refer to you.

    Name: ________________________________________ Age: __________ Sex: ____________________


    Address/School: ______________________________________ Grade/Section: _________________
    Chief Complaint: ____________________________________________________________________
    ____________________________________________________________________
    Tentative Diagnosis: ____________________________________________________________________
    Remarks: ______________________________________________________________________________

    _____________________________
    Name and Signature
    _____________________________
    Designation

    =========================================================================
    Note: To be detached from upper portion and sent back to school.

    RETURN SLIP

    Return to __________________________________
    Name of Patient: _____________________________________ Date Referred: ___________________
    Chief Complaint: _____________________________________
    Findings: ______________________________________________________________________________
    Actions/Recommendations: ____________________________________________________________

    Attested by:

    _____________________________
    Name and Signature
    _____________________________
    Designation

    Kawit Elementary School


    Purok Maligo, Polomolok, South Cotabato
    School ID: 130725
    Facebook Page: DepEd Tayo Kawit ES
    Kawit Elementary School
    Purok Maligo, Polomolok, South Cotabato
    School ID: 130725
    Facebook Page: DepEd Tayo Kawit ES

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