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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 and select Nurse Stone.*
 
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.
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

Sports Physical Exam Form

In order for a middle school student to participate in after-school sports activities, the student must undergo a physical exam. Check with the middle school that your child attends to find out the specific due dates for return of this form, as that date varies based on the season during which the sport is played.
 
(Health History Update Questionnaire)
 
NEW: A pamphlet titled, Sudden Cardiac Death in Young Athletes is now part of the Sports Physical Exam Form. Parents must acknowledge that they have received and reviewed the information. It may be viewed as part of the packet or directly via the following link. 
 
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.