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LPHS Medical Form Upload

Please use this form to upload annual child health exams and/or immunization requirements. Please also use this form if you have updated vision and/or dental exams.

An email will be sent to those students who are still missing their annual child health exam and/or required immunizations. Thank you.

More information and the forms can be located HERE.

Parent / Guardian Name*

Answer Required

Parent / Guardian Contact Info

Pleaes provide a way to reach you if we have questions or if something is missing.

Answer Required

Student/s Name/s*

Answer Required

Form/s Upload*

Answer Required

Choose a file or drag it here.

Confirmation Email

Enter your email address here if you'd like to receive a confirmation upon submitting the form.

Email Required