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Health Record

The Health Record must be completed and submitted to Butler College Allied Health Office on or before the first day of class. The Health Record must be completed no earlier than 9 months before the first day of class . Only the Butler Health Record form may be used, and must be signed by a MD, DO, APRN, or Physician Assistant.

Health Forms for Nurse Aide II

Health record form for Butler Allied Health Department.
Immunization Form – Includes Vaccine record.

Return to Clinical Requirements
Updated July 2014