Student Health Forms
| Medical and Emergency Notification Information Form 2013-14 | The Medical & Emergency Notification Form is to be completed as part of the Online Processing. When you fill out this form online, the information cannot be saved. Complete one form for each student. The top section of the form is for individual information. The family section is below the individual information. You should only need to complete the family section once. If you have multiple children: complete everything for the first child and print the form. Then delete the individual information on the first child and enter the information for the second child, and print. Continue in this manner until you have one form for each student. Please sign and return the forms to St. John of the Cross School ASAP. |
| Health Form (State Physical with Immunization Record) |
MUST BE TURNED IN PRIOR TO THE FIRST DAY OF ATTENDANCE. Required by the State for any age IF the first year in school, otherwise required for K and 6th grade. Exam must be recorded on the state form and be signed by the parent and physician. Note: this state form is good for sports if the physician checks the sports box. 6th grade MUST use this state form- a sports form does not replace the state physical form. |
| School Medication Procedures: Parent Medication Authorization Form and Physician Form | Please read the School Medication Procedures. Students must have a Medication Authorization form on file in the nurse’s office- 2 page form must be complete and signed by the physician AND parent/guardian in order for the student to receive ANY medication at school.This form is required for students who carry their own Asthma Inhalers and epi-pens. Additional/new forms are required if medications are added or changed. |
| Kindergarten Eye Examination Form | All children enrolling in KG are required to have an eye examination by a licensed optometrist or ophthalmologist. This exam must be completed within one year prior to entrance to kindergarten and submitted by Oct. 15th of the kindergarten school year. |
| Dental Examination Form | Required for K, 2nd, and 6th grades. Must be completed within 18 months prior to the May 15th deadline. For example, a child that had a dental exam after Oct.16th of their 1st grade year may use that exam to comply with the 2nd grade requirement |
| Asthma/Allergy Action Card | Please have this form completed by the physician prescribing a plan of action for specific emergency responses for asthma, food allergies, insect stings, etc. If you have questions please contact the school nurse. |
