2023-24 Screening Form B School Health Services Report

1. Preparer Information *This question is required.

First Name

Last Name

Job Title

Phone Number (###-###-####)

Email address This question requires a valid email address.

2. LEA & Charter School Information *This question is required.

Your County

LEA or Charter School Name and Number
Note: LEAs are listed first, then charter schools

3. Please upload Screening Form B

Download the Screening Form B spreadsheet provided on the 2023-2024 School Health Services Resources webpage and save it to your computer. After entering your local information, you must re-save it to your computer keeping the document title (file name) intact and inserting your district name at the beginning of the title. After compiling responses on the spreadsheet and saving it to your computer, using the correct file name as described above, you will use the link provided below to ‘upload’ your spreadsheet and submit the report form. Click 'Browse' and locate the saved file on your computer. Attaching the document from a cloud-based account, i.e. Google Drive, is not an allowable function. Once you have selected the file, it will show in the report survey. Next click ‘Submit' to upload your document in the report survey.

File name example: BurkeScreening2023-24.xlsx *This question is required.

File: {{filename}} delete