FFA(EXHIBIT) - STUDENT WELFARE: WELLNESS AND HEALTH SERVICES

WELLNESS POLICY ASSESSMENT FORM

Campus Name

Campus Wellness Team Contact Person:

Name

Phone

E-mail

Date of Assessment Completion

NOTE: Please submit a completed copy of this assessment to:

Student Health Advisory Committee (SHAC)

ATTN: Administration Building

South Texas ISD

FFA(EXHIBIT)-X

LDU-22-06

DATE ISSUED: 5/29/2006