FORM PERSIAPAN PELAKSANAAN PKG ANAK SEKOLAH
PREPARATION FORM FOR IMPLEMENTATION of PKG (FREE HEALTH CHECK-UP) FOR SCHOOL CHILDRENSalam Hormat Bapak dan Ibu.
Perkenalkan kami Tim Usia Sekolah dan Remaja dari Puskesmas Pancoran. Mohon ijin Bantuan Bapak dan Ibu atau peserta didik untuk dapat mengisi kuesioner Pelaksanaan Skrining Kesehatan atau CKG Sekolah.
Kegiatan ini dilaksanakan berdasarkan Surat Edaran Kementerian Kesehatan Nomor HK.02.01/MENKES/731/2025 tentang Peningkatan Pelaksanaan Cek Kesehatan Gratis Ulang Tahun dan Pelaksanaan Cek Kesehatan Gratis Sekolah dan Surat Edaran Sekretaris jenderal Kementerian Agama Nomor 22 Tahun 2025 tentang Dukungan Pelaksanaan Pemeriksaan Kesehatan Gratis di Madrasah, Satuan Pendidikan Keagamaan, dan Pesantren.
Pengisian kuesioner bersifat WAJIB dan tujuan pelaksanaannya untuk mendapatkan data kesehatan dasar anak sekolah dan kerahasiaan data akan kami jaga.
Atas perhatian dan kerjasama Bapak dan Ibu kami ucapkan Terimakasih.
Keterangan Tambahan :
1. SMP / Sederajat :- Kelas 7 Laki-laki dan perempuan akan dilakukan pemeriksaan Hemoglobin (skrining anemia) dan Skrining Gula Darah Sewaktu (GDS)
- kelas 9 Perempuan akan akan dilakukan pemeriksaan Hemoglobin (skrining anemia)
2. SMA / Sederajat :
- Kelas 10 dan Kelas 12 Perempuan akan dilakukan pemeriksaan Hemoglobin (skrining anemia)
- Kelas 10, 11 dan 12 akan dilakukan Skrining Gula Darah Sewaktu (GDS)
Salam Sehat,
Puskesmas Pancoran
Greetings of respect.
We are the School-Age and Adolescent Health Team from Pancoran Community Health Center (Puskesmas Pancoran). We kindly request your assistance, as well as that of your students, in completing the Health Screening Implementation Questionnaire for Schools.
This activity is carried out based on:
Circular Letter from the Ministry of Health No. HK.02.01/MENKES/731/2025 concerning the Enhancement of Free Health Check-ups for Birthdays and Free School Health Screenings, and Circular Letter from the Secretary General of the Ministry of Religious Affairs No. 22 of 2025 concerning Support for the Implementation of Free Health Screenings in Madrasahs, Religious Educational Institutions, and Islamic Boarding Schools (Pesantren).
Filling out this questionnaire is MANDATORY, and its purpose is to gather basic health data of school children. We assure you that all collected data will be kept confidential. We sincerely thank you for your attention and cooperation.
Additional Information:
Junior High School (SMP) / Equivalent:
Grade 7 (both boys and girls): Hemoglobin (anemia screening) and Random Blood Glucose (RBG) screening.
Grade 9 (girls only): Hemoglobin (anemia screening).
Senior High School (SMA) / Equivalent:
Grade 10 and Grade 12 (girls only): Hemoglobin (anemia screening).
Grade 10, 11, and 12 (all students): Random Blood Glucose (RBG) screening.
Stay healthy,
Puskesmas Pancoran