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KanCare - KAN Be Healthy

Early and Periodic Screening, Diagnostic, and Treatment Screening. Required fields marked with an asterisk *

Student First Name*

Answer required for "Student First Name"

Student Last Name*

Answer required for "Student Last Name"

You can pick up the form from the school office, or download it here:

Once you've had a health care provider complete your KAN Be Healthy form, bring it to the school office, or upload it here.*

Answer required for "Once you've had a health care provider complete your KAN Be Healthy form, bring it to the school office, or upload it here."

I will bring my form into the school office

I will upload my form here

Upload form if applicable

Answer required for "Upload form if applicable"

Choose a file or drag it here.