Health Office

Dear Campbell Hall Community,


In preparation for the 2014-2015 school year, please familiarize yourselves with the two-part Health Office Registration.

Part 1: Please submit the online InfoSnap form. You will receive an email around Spring Break from that provides specific login directions to complete the form.

Part 2a: Please complete the packet of hardcopy forms you will receive in a mailer from the Health Office midway through April (these forms are also provided below). There are two required forms for every student: the Physical Form, and the CA Report of Health Exam as proof of immunization.

Part 2b: Also, please review the following three situations that may apply to your child. First, if your child is entering 7th grade, he or she is required to receive a Tdap Booster shot according to Assembly Bill 354. Second, if your child does not receive immunizations, the physician must fill out the CA Personal Beliefs Exemption Form. Lastly, if your child requires medication to be administered on campus or on field trips, please fill out one Medication Form for each medication. Below is a checklist of requirements for your convenience.

After completing the forms, please remember to make copies for your own personal records. Using the envelope provided in the Health Office mailer, please return the original hardcopy forms to the Health Office by mail or in person before Tuesday, July 1, 2014.



Due by

required for every student

Submit Online

June 2

Physical Form
required for every student

Green hardcopy

July 1

CA Report of Health Exam
required for every student as proof of immunization

White hardcopy

Tdap Booster Shot
required for rising 7th graders only


CA Personal Beliefs Exemption to Required Immunizations
required if student does not receive immunizations

White hardcopy

Medication Form
complete if necessary – one form for each medication

Yellow hardcopy

If you have any questions, please contact the Health Office.






    Kelly Moulton, RN
    School Nurse
    Office: 818.505.5355
    Fax: 818.505.2460
    Catherine LaGaly
    Administrative Assistant
    Office: 818.505.5327
    Fax: 818.505.2460