Medical Information Form (MEDIF)

To be Completed by Parent

NEW JAZEERA

Language School

Student Information

Student National ID

Student Name (EN)

Student Name (AR)

Medical History

Has the student ever been diagnosed with any medical conditions? If yes, please provide details:

Medications

Medications "Not allowed"

Food "Not allowed"

Recommendations

I hereby confirm that the information provided in this student medical report is accurate to the best of my knowledge. I understand the importance of notifying the school about any changes to the student's medical conditions or medication.

Parent Signature

Emergency phone