School Nurse Forms | Teacher-to-Nurse Passes, Injury Incident Report, Notes Home & Lost Tooth
Keep communication between teachers, the health office and families clear and quick. This set gives teachers simple ways to send students and concerns to the nurse, and gives nurses ready-to-go return slips, reports and notes home.
What's inside
- 25-page print-ready PDF plus a fully editable Word file
- Teacher to nurse: Health Office Pass (4 per page, with reason and urgency), Teacher-to-Nurse Referral for non-urgent concerns, Quick Concern Notes and a Vision & Hearing Observation Checklist
- Nurse to teacher: Health Office Return Slips (4 per page), Classroom Health Summary, Substitute Teacher Health Information, Field Trip Health Checklist and a classroom first aid kit request
- Reports and logs: 2-page Student Injury/Incident Report with body diagram, a full-page body diagram and a Daily Health Office Visit Log
- Notes home: Visited the Health Office Today, Minor Injury, Bump to the Head (with CDC HEADS UP danger signs), Went Home Sick (editable return-to-school box), Clothing/Supplies Request and Health Screening Results
- Lost Tooth Club: I Lost a Tooth at School Today certificates, fold-and-glue tooth envelopes and a class chart
LOW PREP: Print a stack of passes and return slips for every classroom. In the Word file, use Find & Replace to add your school name, nurse name and phone number once.
Please note: These are editable templates, not medical or legal advice, and they do not replace your district's required forms or protocols.
License: one school site.
Designed by a classroom teacher and instructional coach. Illustrations are created with AI tools; all content is written and reviewed for standards alignment and classroom use.
