Health department city and district Hof

 

Online form anamnesis sheet school entrance examination

 

 

 

Welcome to the online form for the school entry examination of the city and district of Hof!


Completion of the following medical history form is voluntary and serves to better prepare for the respective individual case as well as anonymous data collection for the Bavarian State Office for Health and Food Safety.

 

 

 

 

Sprachauswahl / select language

Details of the parents/guardians

Personal data of the legal guardian
Details of the other legal guardian

Details of the child

Personal data of the child

For a clear and error-free assignment, please use the data from your childs invitation letter.

Kindergarten

Details of kindergarten attendance

Pregnancy, birth and development

Details of the course of pregnancy
Details of development of child

Support measures and treatments

Details of support measures and treatments

Pre-existing conditions and health restrictions

Details about diseases of the child
Further details on severe hearing disorders
Details of the identified metabolic/hormonal disease

Further voluntary information from the legal guardians

Voluntary information provided by legal guardians

Providing the following information is voluntary. However, your information is important for the further development of preventive measures. Further information on data processing can be found in the data protection information that you received with the invitation to attend the school entrance examination.

Your responses will be sent to the Regional Office for Health and Food Safety in anonymised form. If you revoke your consent by notifying the health authority responsible for you before sending it over to the Regional Office for Health and Food Safety, this data will not be transmitted to the Regional Office for Health and Food Safety. If you revoke your consent after it is sent to the Regional Office for Health and Food Safety, it is possible that your data has already been merged with other data and evaluated anonymously and therefore a revocation can no longer be implemented.

Declaration of consent:


As legal guardian(s) of

Details for 1st parent
Details for 2nd parent