Public Forms

  • Here are links to the most common forms used by the public, parents, doctors, businesses, and the community in general.
     

    HEALTH SERVICES
    AD-H-516 Allergy/Anaphylaxis Action Plan Download pdf
    AD-H-434 Individualized Seizure Protocol for Uncontrolled Seizure Disorder Download pdf
    FSD-49 Medical Statement for Students Requiring Special Meals Download pdf
    AD-H-326 Medical Form for Administration of Medication and Self Medication Administration Download pdf
    AD-H-358 Medical Order:  Gastrostomy/Jejunostomy Tube Feedings Download pdf
    AD-H-503 Medical Statement / Asthma Action Plan Download pdf
         
         
    TRANSFERS
    AD-102 Application for Student Transfer (2019-20 sch yr)
    Download pdf
    AD-122 Student Transfer Appeal Download pdf
         
         
    TRANSPORTATION
    AD-T-209 Parental Concern Download pdf
    AD-T-211 School Bus Complaint Download pdf
    MO-106 How To Get There (Directions to Schools) Download pdf
         
         
    FACILITY USE
      Facility Use Information Link to page
         
         
    ENROLLMENT
    CI-276 New Student Enrollment Download pdf
    CI-276 Spanish Inscripción para de estudiantes nueuos New Student Enrollment (Spanish) Download pdf
    CI-277 Student Medical Profile Download pdf
    CI-277 Spanish Perfil Médico Estudiantil del Condado de Knox Download pdf
     
     
    STUDENT RELATED
    - Special Education, rights, safeguards, medical release
    CI-130 Notice of Appeal of Long-Term Suspension/Expulsion (For Suspensions and Expulsions of five (5) Days or More) Download pdf
    CI-168 Parent Referral to S-Team 
    NOTE: This form is 8.5 x 14 (legal). To print on MAC, select Page Setup (under file on the menu) paper size should be legal. On a PC select print, then properties and choose legal.
    Download pdf
    CI-190 Parent Communication Form Download pdf
    CI-191ABCDE Student Athletics – Preparticipation Physical Evaluation and Consent for Athletic Participation  (History/Physical Examination/Clearance/Consent/Special Needs: Supplemental History) Download pdf
    CI-200 Notice of Parent and Student Rights Under Section 504 Download pdf
    CI-202 Request for Short-Term Suspension Review (For Suspensions from School of Four (4) Days or Less) Download pdf
    CI-246 Optional Medical Release
    (for use with field trips)
    Download pdf
    CI-246Sp Permiso Médico Opcional   Download pdf
    FSD-49 Medical Statement for Students Requiring Special Meals Download pdf
    MC-107 Access to Electronic Media Download pdf
    MC-107Sp Acceso a los Medios Electrónicos Download pdf
    MC-108 Guidelines For Access to Electronic Media Download pdf
    MC-108Sp Pautas para el Uso Aceptable de los Medios Electrónicos Download pdf
    MC-114 Citizen's Request for Reconsideration of Instructional Materials Download pdf
    PP-155 Special Education Services Available Through Knox County Schools Download pdf
    PP-156 Notice of Procedural Safeguards Download pdf
     
     
    PUBLIC AFFAIRS
    - Media releases, comments, request for production, volunteer background check authorization
    PA-100 Student Media Release Form Download pdf
    PA-100Sp Autorización de los padres/guardianes para la divulgación publicitaria Download pdf
    PA-102 Comment Card Download pdf
    PA-103 KCS-TV Video Production Download pdf
    PA-104 Background Investigation Disclosure/Authorization for Volunteers
    (for levels 3 and 4 parent volunteers)
    Download pdf
    PA-105 Volunteer Confidentiality Agreement Download pdf
    PA-107 Open Records Request Form Download pdf
     
     
    EMPLOYEES
    BO-106 Flexible Benefit Plan Compensation Reduction Agreement Download pdf
    BO-121 Tax Shelter Payroll Deduction/Change Authorization Download pdf
    BO-130 Employee Medical History Download pdf
    BO-132 Knox County Check Request Download pdf
    BO-133 Classified Sick Leave Bank Request Download pdf
    BO-134A Travel Expense Reimbursement/Summary LOCAL TRAVEL ONLY
    BO-134B Travel Expense Reimbursement/Summary OUT OF TOWN TRAVEL
    BO-135 Certified Employees' Sick Bank Enrollment Request Download pdf
    HR-136 Cancellation Notification for Automatic Deposit Download pdf
    BO-138 Classified Sick Leave Bank Enrollment Request Download pdf
    HR-141 Authorization Agreement for Automatic Deposits (Credit) Download pdf
    BO-149 Certified Sick Leave Bank Physician's Statement Download pdf
    BO-150 Certified Sick Leave Bank Request to Use Sick Leave Days from Sick Leave Bank for Employee's Personal Illness Download pdf
    HR-156A Authorization and Request of Protected Health Information (PHI) – MENTAL HEALTH (for employees) Download pdf
    HR-156B Authorization and Request of Protected Health
    Information (PHI) – MEDICAL INFORMATION (for employees)
    Download pdf
    BO-157 Leave Request Download pdf
    BO-161 Payroll Deduction/Change Authorization Download pdf
    BO-162 Classified Sick Leave Bank Physician Statement Download pdf
    BO-164 Classified Sick Leave Bank Membership Cancellation Download pdf
    BO-166 Life Insurance Enrollment/Change Request Download pdf
    BO-176 Vision Insurance Enrollment/Change Download pdf
    BO-177 Health Enrollment Change Application
    (State of TN Group Insurance Program)
    Download pdf
    BO-178 Dental Insurance Enrollment/Change Download pdf
    BO-180A
    BO-180B
    BO-180C
    Insurance Intent
    Leave of Absence - Continue Insurance Coverage
    Leave of Absence - Suspend Insurance Coverage
    Download pdf
    BO-181 Insurance Cancel Request Application
    (State of TN Group Insurance Program)
    Download pdf
    BO-182 Certified Sick Leave Bank Membership Cancellation Download pdf
    HR-102 Physician’s Verification of Illness and/or Maternity Leave Download pdf
    HR-104 Leave of Absence Download pdf
    HR-112 Employee Name and Address Change Download pdf