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    Republic of The Philippines Department of Education Region Xii Division of Sarangani

    Uploaded by

    Nor-Jaina Musa Mina-Calulong
    This document is a notification letter from an elementary/secondary school to parents about upcoming health services provided to students in coordination with the Department of Health and Local Government Unit. It lists several services like general health exams, oral health exams, deworming programs, iron supplementation, and immunization programs for various grades. Parents are asked to acknowledge receipt of the letter and consent to allow their child to participate or not and provide a reason if not consenting. The principal's signature is on the letter encouraging parents to contact them with any questions.

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd

    Republic of The Philippines Department of Education Region Xii Division of Sarangani

    Uploaded by

    Nor-Jaina Musa Mina-Calulong
    18 views2 pages
    This document is a notification letter from an elementary/secondary school to parents about upcoming health services provided to students in coordination with the Department of Health and Local Government Unit. It lists several services like general health exams, oral health exams, deworming programs, iron supplementation, and immunization programs for various grades. Parents are asked to acknowledge receipt of the letter and consent to allow their child to participate or not and provide a reason if not consenting. The principal's signature is on the letter encouraging parents to contact them with any questions.

    Original Description:

    parent consent

    Original Title

    Universal Consent

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    This document is a notification letter from an elementary/secondary school to parents about upcoming health services provided to students in coordination with the Department of Health and Local Government Unit. It lists several services like general health exams, oral health exams, deworming programs, iron supplementation, and immunization programs for various grades. Parents are asked to acknowledge receipt of the letter and consent to allow their child to participate or not and provide a reason if not consenting. The principal's signature is on the letter encouraging parents to contact them with any questions.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    18 views2 pages

    Republic of The Philippines Department of Education Region Xii Division of Sarangani

    Uploaded by

    Nor-Jaina Musa Mina-Calulong
    This document is a notification letter from an elementary/secondary school to parents about upcoming health services provided to students in coordination with the Department of Health and Local Government Unit. It lists several services like general health exams, oral health exams, deworming programs, iron supplementation, and immunization programs for various grades. Parents are asked to acknowledge receipt of the letter and consent to allow their child to participate or not and provide a reason if not consenting. The principal's signature is on the letter encouraging parents to contact them with any questions.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 2

    Republic of the Philippines

    Department of Education
    Region XII
    DiVISION of Sarangani
    EAST MAITUM
    Date: __________________________________________________________________
    Name of School: _________________________________________________________
    Address: _______________________________________________________________
    Name of Learner: ________________________________________________________
    Address: _______________________________________________________________
    Name of Parent/Guardian: ________________________________________________

    Dear Parent/Guardian;

    This school, a Public Elementary/Secondary School, will conduct the following Health Services to the
    children in coordination with the Department of Health (DOH) and the Local Government Unit (LGU).
    -General Health Examination and Appropriate Intervention (Anytime of the School Year)
    -Oral Health Examination and Appropriate Intervention (Anytime of the School Year)
    -School Based Deworming Program (July, 2018 and January, 2019)
    -Weekly Iron Folic Acid (WIFA) Supplementation for Grade VII-X Female
    -School Based Immunization Program (August,2018 and February, 2019)
    Grade I - MCV and TT
    Grade IV- HPV
    Grade VII- MR and TT
    This notification is being issued to you as information of the activity that will be conducted on SY 2018-
    2019 to all school children.

    Should you have further questions/clarifications on this matter, please get in touch with the
    principal/School head.

    Thank you.

    Very truly yours,

    _______________________
    School Principal/School Head
    ACKNOWLEDGEMENT AND CONSENT
    This is to acknowledge receipt of the notification letter regarding the conduct of free School
    Based Health Services.
    I have read and understood the information regarding the intended health services to be given
    to my child.
    (Please check the box)
    YES, I will allow my child to be provided the Health Services as per DOH recommendation
    Yes, I will allow but only for these services ______________________________________
    No, I will not allow my child to receive the Health Service benefits
    Reasons: _____________________________________________
    _____________________________________________
    _____________________________________________
    _____________________________________________

    Signature of Parent/Guardian: ________________________________________


    Name of Parent/Guardian: ___________________________________________
    Date: ____________________________________________________________

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