Irlam Primary School

Health and Well-Being Form

Please complete this form to allow us to plan for September. It is important that we have correct and up to date information to help us carry out individual risk assessments and to make sure that we can make school as safe as possible for everyone. Please refer to the definitions in the email that you were sent in order to answer the questions accurately. The information provided in this form will be treated in the strictest confidence and will only be used to help us assess and mitigate any risks to your health and the health of your family. If you don't wish to disclose the information that has been requested, please speak to Elaine or Lindsey. Once submitted a small green bar will appear at the top of the screen which will say 'Thank you for your form submission'. You can then close the form.