STUDENTS PARENTS ALUMNI FACULTY

Medical Office

If you have any questions please contact the nurse at (856) 461-5400 ext. 3023.

Please return all Medical forms to the Main Office or the Medical Office: ”Attn School Nurse”

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FRESHMEN AND TRANSFER STUDENTS:

A Preparticipation Physical Evaluation (PPE) must be presented before the first day of school.  Please ask your physician to attach a copy of your student’s immunization record. Please also ask your physician to complete any medication forms that are applicable to your child.

Forms:

Part A: Health History Questionnaire

Part B: Physical Evaluation Form

Authorization for Medication to Be Given During School Hours- All medication must have a medical prescription and parental request.It must be in the original container and clearly labeled.

Permission Form – Drive Home Sick

Asthma Action Plan- available for download from the school website must be completed if your student has asthma documented on the history and physical, and/or your student carries an inhaler.

Food Allergy & Anaphylaxis Emergency Care Plan -must be completed if your student has a documented life threatening allergy and/or carries an EpiPen.

Diabetes Medical Management Plan/ Individualized Health Plan - Click to view a sample plan template.  A DMMP/IHP must be completed if your student has a documented diagnosis of diabetes.

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STUDENTS PARTICIPATING IN SPORTS:

An annual physical is required for any student participating in sports.  Physicals are good for one calendar year.  A new physical must be completed every 365 days. Any athlete that uses an inhaler or an EpiPen MUST have a healthcare plan.

Forms:

Part A: Health History Questionnaire

Part B: Physical Evaluation Form

Consent and Acknowledgement Signature Form-  Read the policies and information below prior to completing the Consent and Acknowledgement Signature Form.

Athletic Participation Form

Two (2) Emergency Information Cards

Please make certain that all forms are signed by both the parent/guardian and the student as indicated. Make sure the Physical Evaluation form is completely filled out, signed and stamped by the examining physician.  Incomplete forms will be returned and will delay your student’s participation in sports.

If your athlete participates in more than one sport, the following forms must be resubmitted for each sport:

Part A: Health History Questionnaire

Athletic Participation Form

Two (2) Emergency Information Cards