Certificate of Physical Examination Form Submission

The Certificate of Physical Examination Form is required as a part of enrollment at Yokohama International School, and must be completed by a certified healthcare provider within 6 months of your child's enrollment date.

Download the Certificate of Physical Examination Form here.

Parent Name *

Parent Email Address *

Message Subject *

Student Name *

Last Name, First Name [Preferred Name, if applicable]

Student Grade Level Accepted at YIS *

Certificate of Physical Examination *

Please upload a copy of the completed form as a single PDF containing health data related to a single child.

By pressing Submit, I understand that the information provided in the attached Certificate of Physical Examination Form will be shared with appropriate school staff in order to provide for the health and safety of my child.

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Certificate of Physical Examination Form Submission

Thank you for your submission!