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School Nurse & Medical Forms for Students » Home

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*To access the website for the nurses, please click the staff link to the right.*
 
Your child's health is very important to us. Providing medical information about your child assists us in responding appropriately to support student health and health maintenance. Please click on the title of the forms from the list below, complete as required, and return to your child's school nurse at your earliest convenience.
This form provides important allergy information to school medical personnel so that an appropriate individualized health care plan is in place during the time the affected student is in the school environment.
Diabetes Management Plan
This form provides important diabetes management information to school medical personnel so that an appropriate individualized health care plan is in place during the time the affected student is in the school environment.
Asthma Treatment Plan
This form provides important asthma treatment information to school medical personnel so that an appropriate individualized health care plan is in place during the time the affected student is in the school environment.
Health Immunization Requirements for Sixth Graders/11-Year-Olds
The NJ Department of Health and Senior Services requires parents/guardians to provide updated immunizations records for their child prior to the child entering sixth-grade or reaching 11 years of age.
It is the district's practice that students with peanut/nut allergies are seated at a "peanut/nut-free" table during lunch. Parents/guardians wishing their child to be seated at a regular table must complete requirements outlined in these documents.
This form provides information regarding Opioid Use and Misuse.
Permission to Administer Medication During School
This form grants permission to the appropriate school personnel to administer medication to a student during school hours.
Permission for Designee to Administer Epi-Pen and Waiver of Liability
This form allows parents/guardians to grant permission for a designee to administer an epi-pen to their child during the school day.
 
This form allows parents/guardians to request permission for a student to carry and use an inhaler or epi-pen while on or off school property.
Routine Physical for Fourth and Seventh Graders
Although not required, the district recommends that a child have a physical exam in fourth and seventh grades.
Seizure Action Plan
Questionnaire for Parent of a Student with Seizures and Seizure Action Plan
The forms above provides important seizure treatment information to school medical personnel so that an appropriate individualized health care plan is in place during the time the affected student is in the school environment.
Sports Related Eye Injuries
Please take a moment and review this informational on Sports Related Eye Injuries.
FOR MIDDLE SCHOOL STUDENTS ONLY
 
Please carefully read, sign, and print the complete packet of athletics information, which consists of the Sports Physical Exam Form, the Sports Repeater Form, the Sports-Related Concussion and Head Injury Fact Sheet and Parent/Guardian Form/Sign Off, Opioid Use and Misuse Educational Fact Sheet/Sign Off, and Sudden Cardiac Death in Young Athletes/Sign Off.
 
Athletics Information
This includes the Sports Physical Exam Form, the Sports Repeater Form, the Sports-Related Concussion and Head Injury Fact Sheet and Parent/Guardian Form/Sign Off, Opioid Use and Misuse Educational Fact Sheet/Sign Off, and Sudden Cardiac Death in Young Athletes/Sign Off.
 
Sports Repeater Form/Health History Update Questionnaire - Found on page 6 of the Athletics Information (above).
 
Please read this document when completing the sports physical.
 
Please carefully read and complete this information if it applies.
 
Consent for School Physician to Conduct Sports Physical Exam
Sports physicals for seventh and eighth graders, as well as for incoming sixth graders, must be conducted by the student’s personal medical doctor/medical facility. The only exception is for parents of those students who have qualified for free or reduced lunch. Your children may be eligible for a sports physical to be performed at school. Please contact your middle school’s nurse for further instructions before completing this form.