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Parent Resources » Health Forms

Health Forms

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 download the necessary forms from the list below, complete as required, and return to your child's school nurse at your earliest convenience.

Allergy Action Plan - Food and Non-Food - and Waivers of Liability
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.
 

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.

 

Concussion Fact Sheet

This handout is published by the New Jersey Department of Education and provides information regarding head injuries and concussions.  The handout also includes signs and symptoms of concussions.

 

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.

 

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.

Opioid Fact Sheet

The Opioid Fact sheet is co-authored by the New Jersey Department of Health, the New Jersey Department of Education, and the NJSIAA Sports Advisory Committee.  This is a resource intended to assist parents in opioid use and misuse with suggestions on how to keep student athletes safe from injury.

Peanut/Nut-Free Table & Release and Hold Harmless Agreement

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 this document.

 

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 Self-Administration of Epi-Pen and/or Inhaler and Waiver of Liability
This form allows parents/guardians to grant permission for their child to self-administer an epi-pen or inhaler during the school day.


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.

Sudden Cardiac Death Brochure

This brochure, published by the American Heart Association, contains important information about sudden cardiac death in young athletes.