Registration Forms

Parent Registration Forms

Parental/Guardian Permission Form Concerning Treatment
Consentimiento De Los Padres/Tutores Legales Para Recibir Tratamiento

To enroll in an Integrated Health Services School Based Health Center, or to refer a student who is currently enrolled in a participating school for services, select and complete from the forms below. Once submitted, forms will be sent directly to a Program Administrator for follow-up.

School Based Health Center Forms

Contact IHS

Integrated Health Services:

Mailing Address
P.O. Box 280083
East Hartford, CT
06128

Physical Address
87 Church Street, Unit 206 J
East Hartford, CT
06108

(860) 291-9154

Hours:
Monday-Friday: 8:00 AM to 4:00 PM
Saturdays and Sundays: closed

About IHS

Integrated Health Services, Inc. was founded in 2007 by Dr. Poerio, DNP, APRN, FNP-BC, but the organization’s purpose – to provide comprehensive, accessible, and integrated health care services at local schools – had been cultivated over the previous fifteen years while she ran the School Based Health Center (SBHC) program at Manchester Memorial Hospital.

Locations


​​​​IHS Administrative Office

Mailing Address
P.O. Box 280083, East Hartford, CT 06128

Physical Address
87 Church Street, Unit 206 J, East Hartford, CT 06108

(860) 291-9154

Administrative Office Hours
Monday-Friday: 8:00 AM to 4:00 PM
Saturdays and Sundays: closed

School Based Health Center Locations
Connecticut River Academy High School
9 Riverside Drive
East Hartford, CT 06118
(860) 929-3164

Connecticut River Academy Middle School
195 Riverside Drive
East Hartford, CT 06118
(860) 929-3020

Riverside Magnet School
29 Willowbrook Road
East Hartford, CT 06118
(860) 709-6812

Carmen Arace Intermediate and Middle Schools
390 Park Ave
Bloomfield, CT 06002
(860) 286-2622 ext.2608