SBHC Medical Service Request rev20211001 Parent/Guardian Name(Required) First Last Child's Name(Required) First Last Phone(Required)Email What school does your child attend?(Required) Catherine Kolnaski Magnet School Groton Middle School Fitch Senior High School Mystic River Magnet School Thames River Magnet School Bennie Dover Jackson Middle School Jennings Elementary School Nathan Hale Elementary School New London High School Regional Multicultural Magnet School Winthrop Elementary School Stonington Middle School The Friendship School Other Services requested(check all applicable) Physical Flu vaccination Other vaccination Other service Other services/vaccination requested (explain)(Required)Disclaimer: We are currently receiving a high volume of requests for services. Please expect return contact for scheduling in 2-3 days. For urgent or emergent requests please call 911, or go to the nearest emergency department for assistance.