Health Services

School Nurse - Heather Shupenko  - shupenkoh@georgetown.k12.ma.us - (978)352-5790 ext. 3025

Medication Physician Order & Parental Consent Form

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Commonly Asked Questions about Meningococcal Disease and Students

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Concussion Information

• Fact Sheet for Athletes

• Factsheet for Parents

• Factsheet for Teachers & Coaches

• Post-concussion Action Plan

• Report to be filled out, if you have a head Injury during sports season

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EMERGENCY ACTION PLAN for students at High Risk for Severe Allergic Reaction

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Immunizations Information

Immunizations not only help you protect your child against serious childhood diseases, they protect the health of other students. Below are the vaccines required to attend school in Massachusetts.

Required Immunizations: The following immunizations must be on file with the school nurse prior to starting classes:

Pre-School: 3 doses of Hepatitis B, 4 or more doses of DTaP/DTP, 3 or more doses of Polio, 1-4 doses of Hib, 1 dose of MMR, 1 dose of Varicella

Kindergarten: 3 doses of Hepatitis B, 5 doses of DTaP/DTP, 4 doses of Polio,  2 doses of MMR, 2 dose of Varicella

Grade 1-6: 3 doses of Hepatitis B, 4 or more doses of DTaP/DTP, 3 or more doses of Polio, 2 doses of MMR.  Grades 1-3 need 2 doses of Varicella, Grades 4-6 need 1 dose of Varicella.

Grade 7-10: 3 doses of Hepatitis B, 4 or more doses of DTaP/DTP plus 1 Tdap booster, 3 or more doses of Polio, 2 doses of MMR, and 2 doses of Varicella.

Grade 11-12: Grade 7-10: 3 doses of Hepatitis B, 4 or more doses of DTaP/DTP plus 1 Tdap booster, 3 or more doses of Polio, 2 doses of Measles, 1 dose Mumps, 1 dose Rubella, and 1 doses of Varicella.

Failure to provide the school nurse with documentation of these immunizations is cause for exclusion from school.

Allowable Exemptions: There are two situations in which children who are not appropriately immunized may be admitted to school:

1. Medical Exemption is allowed if a physician submits documentation attesting that an immunization is medically contraindicated.

2. Religious exemption is allowed if a parent or guardian submits a written statement that immunization conflict with their sincere religious beliefs.

Philosophical exemptions are not allowed by law in Massachusetts, even if signed by a physician.

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Medication Physician Order & Parental Consent Form