Clinic 

FORMS

School Entrance Form    Required for all Pre K, Kindergarten & all new families  

Medication Authorization Form  Used for both over the counter and prescription medications. Physician's signature is required for prescription medications. 

Asthma Action Form Used for student's with asthma. Physician's signature is required. 

Severe Allergy/Anaphylaxis Action Plan & Treatment Authorization Used for student's with life-threatening food allergies. Physician's signature is required. 

Important Information about Immunization Requirements Effective July 1, 2021

Effective July 1, 2021 there are new immunization requirements for incoming Kindergarten students and students entering 7th grade. Please be advised of these changes so you can be sure to make appointments for this summer. You will have to meet these requirements before the first day of school.

1.      Two properly spaced doses of hepatitis A vaccine (HAV). The first dose shall be administered at age 12 months or older.

2.      Two properly spaced doses of meningococcal conjugate vaccine (MenACWY). The first dose shall be administered prior to entry to seventh grade. The second dose shall be administered prior to entry to twelfth grade. (7th grade only)

If you have any questions or concerns about the above mentioned vaccines please contact your physician to discuss your concerns. 

Medication

• If your child needs a medication, please ask the physician to space the dosages around school time (for home administration).  If this is not possible, please print and complete the appropriate medication form.  Remember that each medication has its own form.  

• All medications must be in the original prescription container with the following information: student’s name, license prescriber’s name, medication name, medication dosage, administration frequency, and the prescription fill/expiration dates.  Medications cannot be administered out of plastic bags or other non-original containers. 

• No medication (prescription or non-prescription) is permitted in the classroom at any time including Aspirin, Tylenol, cough drops, etc.  

• All over-the-counter medications must be brought to the office in their original container upon arrival to school. 

• At the end of the school year, the parents/guardians must pick up the remaining medication.  We are not able to release medications back to the student.  Upon school closure, any remaining medication will be disposed of.

SCOLIOSIS INFORMATION 

What is scoliosis?

Scoliosis is a sideways curve of the spine. Instead of a straight line down the middle of the back, a spine with scoliosis curves, sometimes looking like a letter “S” or “C.” An x-ray of the spine is needed to determine if the condition has developed. Scoliosis is defined as a curve of 11 degrees or more. Although scoliosis can develop at any age, the majority of the cases happen during adolescence, when most children are growing rapidly.

As the spine grows, it bends to the side and may twist or rotate. Since ribs are attached to the spine, they can rotate and make the chest look uneven. This twisting can also make the shoulders or waist look uneven.

Common signs of scoliosis include:

• Uneven shoulders and shoulder blades

• Unequal distance between arms and body

• Uneven hips

• Ribs prominence, or ribs that stick out in one area

• Lower back muscle prominence, or muscles that bulge on one side

• Uneven waist folds

Scoliosis is not always painful. Your child may not have pain at all, especially if the curve is mild or moderate. If your child has constant back pain, contact his or her doctor.

About 2 to 3 percent of children have scoliosis. The cause is usually not known. Most children will not have harmful long-term effects, but some will develop serious problems later in life if not treated. A curve in the spine may get worse during the adolescent growth spurt. Once a child is fully grown, a mild curve usually will not get worse.

Untreated scoliosis can cause severe physical deformity, chronic back pain, osteoarthritis, heart problems or lung problems.

Severe cases of scoliosis can cause Curves in the spine that continue to get worse during adult life, heart problems and lung problems

SIMPLE HOME TEST FOR THE EARLY DETECTION OF SCOLIOSIS

·         Is one shoulder higher than the other?

·         Is one scapula (shoulder blade) more prominent than the other?

·         Does one hip seem higher or more prominent than the other?

·         Is there a greater distance between the arm and the body on one side than on the other when the arms are hanging down loosely at the sides?

·         Does the child have excessive "swayback" (lordosis)?

·         Does the child have excessive "round shoulder" or "roundback" (Kyphosis)?

·         Is there a larger "crease" at one side of the waist than the other side?

·         Does the child seem to "list" or lean to one side?

·         When you examine the child, have her bend forward with her arms hanging down loosely with the hands even and the palms touching each other at about the level of the knees.

·         When in this position:

·         ls there a prominence or hump in the rib area?

·         ls there asymmetry in the hips or waist?

lf you have any "yes" answers or if the child has a brother, sister, parent or other close relative with scoliosis, consult your family doctor or orthopedist.