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Medical and Immunization Records

KINDLY ENTER DATA FOR ALL FIELDS. IF ANY FIELDS DO NOT APPLY TO YOU OR CANNOT BE DETERMINED PRESENTLY, PLEASE INDICATE “NA” OR “TBA”.

After submitting the Student Application, you will be given the option to add additional children.

Emergency Contact Information

Please name another local contact other than the parent/guardian.

+65 (Singapore contact number only.)

A) Has your child been vaccinated against the following?















(Please specify)

B) Does your child suffer from, or struggle with, any one of the following?

If YES to any of the above, please specify.
If NO, please write ‘NA’.

Illness

K) Please list any medication your child takes on a regular basis, currently or within the last year, and its purpose. Please indicate ‘NA’ if there’s none.

Add Row

If your child receives regular treatment from a doctor in Singapore, then please provide the following:

Must be a Doctor in Singapore.

Apt Block/House Number

Street Name, Unit Number and/or Building Name

Singapore Postal Code