COMMONWEALTH OF VIRGINIA
DEPARTMENT OF EDUCATION
P. O. BOX 2120
RICHMOND, VIRGINIA 23218-2120
SUPTS. MEMO. NO. 22
February 5, 1999

INFORMATIONAL

TO: Division Superintendents
FROM: Paul D. Stapleton
Superintendent of Public Instruction
SUBJECT: School Health Form HPE-h12 
The Department of Education distributes a number of  School Health
Forms to local school divisions.  These  School Health Forms are
currently being reviewed by the  Department of Health and the
Department of Education.

The following form has been deleted: FORM HPE-h12, THE 
SCHOOL ENTRANCE HEALTH INFORMATION FORM (DATED DECEMBER 
1983).  The information on that form is provided in Part 
I, Health Information Section of the School Entrance 
Physical Examination and Immunization Certification, (MCH 
213C) dated October 1991.

Should you have any questions or comments, please contact 
Gwen Smith, R.N., Student Health Services Specialist at 
(804) 786-8671 or e-mail gpsmith@pen.k12.va.us.

PDS/gs

cc: Gwen Smith