Health Assessments

Students entering Kindergarten: We will accept a Health Assessment Record for a physical completed within one year prior to the start of kindergarten.

Prior to entering 7th grade: We will accept a Health Assessment Record for a physical completed at any time between the first day of a student's 5th grade year and the first day of the student's 7th grade year. Any student who is not in compliance with this state mandate by the first day of 7th grade will be sent home.

Prior to entering 11th grade: We will accept a Health Assessment Record for a physical completed at any time between the first day of a student's 9th grade year and the first day of the student's 11th grade year. Any student who is not in compliance with this state mandate by the first day of 11th grade will be sent home.

Immunizations

The State of Connecticut Health Assessment Record form includes a detailed description of all immunization requirements for newly enrolled students in Connecticut schools.

• State of Connecticut Health Assessment Record (blue) - Grades K-12

• CT State Department of Public Health - Immunization Requirements Summary

If you have any questions, please contact the School Nurse/Health Services office.

Medication Authorization

Authorization for Medicine Form

In order for medication to be dispensed to a student during school hours or while on a school-sponsored event, a medication authorization form must be on file with the School Nurse.

The Authorization for the Administration of Medication by School Personnel form needs to be filled out, signed and dated by the doctor on the upper part of the form. It needs to be signed and dated by the parent on the lower part of the form. The paperwork should be submitted to the school nurse two weeks prior to the field trip for review.

Please note that the Parental Permission for Administration of Standing Orders from District Medical Advisor form allows ONLY the School Nurse to administer Tylenol (for afebrile headaches, dysmenorrhea or orthodontic pain) or Advil (for dysmenorrhea or orthodontic pain), not a teacher. The school nurse generally is not present on field trips. If you feel your child may need Tylenol or Advil on a field trip, an Authorization for the Administration of Medication by School Personnel must be completed by the doctor and the parent, and on file in the nurse’s office prior to the field trip.

Health Services Forms

• Medication Authorization Form

• Health Assessment Record Form

• Medical Exemption Certification

• Asthma Action Plan Form