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Student Physicals for 2017-2018 School Year

April 10, 2017

Students Physicals for
7-12 graders

Monday, April 10, 2017 beginning at 8 - 10am

Cost is $15 per student

(Make checks payable to North Harrison School)

Due with returned forms on or before March 31
*EVERY question MUST be answered
*The form MUST be signed by a parent
*Insurance MUST be noted
*The form MUST be signed by the student

Each packet also contains information on
KEEP this information for future reference!
RETURN ONLY the TWO physical exam information sheets

A physical is REQUIRED if trying-out or participating in cheerleading, softball, baseball, football, basketball and/or track
A physical exam in recommended for marching band students

Physicals will be done by
Dr. Caleb Guernsey, DC from Bethany
Darcy Morey, Family Nurse Practitioner with Eagleville Med Clinic
Tammy Maxwell, Pa-C with North Harrison Med Clinic

Staff from the Therapy Department of the Harrison County Community Hospital will conduct baseline concussion test for new students

Volunteer nurses from our community will assist with blood pressure, height, weight, hearing, and skin checks

The Harrison County Health Department Staff will be here to administer FREE immunizations
(Tdap booster and Meningitis vaccination to those students who will be in 8th grade next year,
Meningitis vaccination to those students who will be SENIORS next year)

This physical is valid for spring cheerleading try-outs, summer camps, and the entire 2017-18 school year
(A physical dated on or after February 1, 2017 is valid for the 2017-18 school year)

This is a great opportunity for ANY student to have a check-up!


2017 - 2018 Physical Form



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North Harrison R-III12023 Fir StreetEagleville, MO  64442

660-867-5221Fax: 660-867-5263

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The North Harrison R-III School District does not allow discrimination or harassment against employees, students or others on the basis of race, color, religion, sex, national origin, ancestry, disability, age or any other characteristic protected by law. Discrimination or harassment is strictly prohibited in accordance with law.The Full Policy is found under the Compliance (Non Discrimination) Section.

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