Clinic: Health Info & Forms

Clinic phone: 703-992-0064

Student Health Forms

Forms to be completed when a student enters St. Ambrose School

Form to be completed at the beginning of each school year

Form to be completed if a student is to be given any medication at school

  • Medication Authorization Form 2023 (Not for epinephrine injections or inhaler. See below if school staff need to be authorized to administer an inhaler or injectable epinephrine to your child.)

Forms to be completed as needed for students with asthma or allergies

Forms to be completed for students with diabetes

Human Papilloma Virus (HPV) Vaccine – Information for parents of rising 6th Grade Girls

  • Letter from Virginia Bishops re: HPV vaccine
  • Virginia Department of Health Information Letter re: HPV Vaccine

Lions Club Sight and Hearing Testing


Resources for parents:

FARE  (Food Allergy Research and Education):  education and support to  parents who need help managing food allergy.

Head Lice information from National Pediculosis Association

Heads Up: Concussion in Youth Sports: The Centers for Disease Control and Prevention has important information for coaches and parents on preventing, recognizing, and responding to a concussion.

St. Ambrose Catholic School

3827 Woodburn Road, Annandale, VA 22003

Phone: 703-698-7171

Fax: 703-698-7170

St. Ambrose School admits students of any race, color, and national origin.

"Christ is everything to us" – St. Ambrose