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Student Medical Questionnaire

Data Protection Act (GDPR) 2018 - The information that you provide on our forms will be held on the computerised database maintained by the college as the data controller. Your data will be used in accordance with the principles set out in the GDPR 2018, which protects the right to privacy of individuals whose personal details are held by the data controller. The Henry Cort Community College will only make details available within the Local Authority; to Hampshire County Council schools and their governance bodies; the Department of Education or any other bodies involved with the care of children in this college. This information is gathered in order to enable the provision of education and other associated functions. In addition, the college may be required by law to collect, use and share certain information. In accordance with Hampshire County Council’s retention schedule we will keep students’ data including religion, and medical information until the child reaches age 22, unless there is a child protection issue, in which case the records will be kept until age 25.

If there are any changes to your child’s medical condition(s) it is the parent’s responsibility to notify us.

 YesNo
Asthma or Bronchitis
Heart Condition
Fits, Fainting or Blackouts
Severe Headaches
Diabetes
Allergies to any medication
Any other allergies
Travel Sickness
Other illness or disability
 YesNo
Has your child received a vaccination against Tetanus during the last 10 years?
Is your child receiving medical or surgical treatment of any kind from the family doctor, hospital or an alternative therapist?
Has your child been given specific advice to follow in emergencies?

Parental / Carer Consent

I am happy for you to give my child Paracetamol and confirm that:*
*

Data Protection Act (GDPR) 2018 - The information that you provide on our forms will be held on the computerised database maintained by the college as the data controller. Your data will be used in accordance with the principles set out in the GDPR 2018, which protects the right to privacy of individuals whose personal details are held by the data controller. The Henry Cort Community College will only make details available within the Local Authority; to Hampshire County Council schools and their governance bodies; the Department of Education or any other bodies involved with the care of children in this college.

Learning For Life