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About GFA
Home
The GFA Difference
Friends History
Mission, Faith and Core Values
Faculty and Staff
Academics
Classical Christian Education
Education as Formation
The Trivium
Habit Formation
The Classical Curriculum
Admissions
Enrollment
Enrollment Procedures
GFA Shadow Day
Tuition Schedule
Pay My Tuition
Grades and Programs
Upper School 7th-12th
Grammar School 1st-6th
Pre-K and Junior Kindergarten
Daycare
Additional Programs
Forms & Docs
GFA Athletics
Student Life
Parent/Student Portal
Honor Roll
The House Program
School Uniforms
School Calendar
Lunch Menu
General Info
Contact & Location
Give
Fundraising at GFA
Employment
Sitemap
Facebook
YouTube
Instagram
Newsletters
General Health Questionnaire
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The following information is needed for school records. Please be as accurate as possible. Do not leave spaces blank—draw a line or write N/A in spaces that do not relate to your child. Thank you.
Student's Full Name
*
First
Last
Name of Parent(s)/Guardian(s)
*
First
Last
Contact Email
*
Immunizations and Date Received
DTP (Diphtheria, Tetanus, and Whooping Cough Vaccination)
*
DTP 1st Vaccine Date
DTP 2nd Vaccine Date
DTP 3rd Vaccine Date
DTP 4th Vaccine Date
DTP 5th Vaccine Date
DTP 6th Vaccine Date
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Polio Vaccination Dates
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Polio 1st Vaccine
Polio 2nd Vaccine
Polio 3rd Vaccine
Polio 4th Vaccine
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MMR (Measles, Mumps, and Rubella)
*
MMR 1st
MMR 2nd
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Hepatitis A Vaccine Dates
*
Hepatitis A
Hepatitis A 2nd
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Hepatitis B Vaccine Dates
*
Hepatitis B 1st
Hepatitis B 2nd
Hepatitis B 3rd
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Remove
Varicella Vaccine Dates
*
Varicella 1st
Varicella 2nd
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My child has *NOT* received immunizations, and I have signed and attached a Certificate of Exemption.
Yes
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Additional Information
Date of most recent physical examination
*
Date of most recent dental examination
*
Date of most recent eye examination
*
The following will help us understand your student better. Please complete as accurately as possible.
My Child has:
*
Frequent Colds
Allergies (if so, of what?)
Ear Infections
Frequent bouts of pneumonia
Diabetes
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Other health issues
Allergies to Medication
*
Special Medications
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Remarks regarding your child’s health or development you want to call to our attention (epilepsy, diabetes, hemophilia, etc.)
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Does your child have any mental or emotional problems? Explain:
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Please list any operations, injuries, or other health concerns
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Other Comments
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Parent or Guardian Signature
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