Asthma Forms
These forms are for asthma management. Includes asthma emergency treatment plan and medication prescription forms.
Allergy Forms
These forms are for allergic reaction management. Includes emergency treatment plan and medication prescription forms.
Diabetes Management plan
For student with diabetes. All forms must be completed appropriately and medications provided to the school nurse no later than the 1st day of the school year.
Seizure Management Plan
This for students with seizures, form should be completed appropriately and submitted to the Nurse with any prescribed medication no later than the 1st day of the school year.
Athletic Physical Package
These forms are for students who will participate in a school sponsored athletic team or squad during the academic year. Valid for 365 days.
Sport physicals must be recorded on New Jersey Department of Education approved physical forms. NO OTHER PHYSICAL FORMS WILL BE ACCEPTED. Only the newest version of forms will be accepted.
The examining healthcare provider must complete all sections of the physical, including the date of the actual physical exam. All physical forms must be stamped with a physician stamp. Sport physicals submitted with incomplete information will be returned to the parent for completion by the health care provider.
Health History Update Questionnaire
This form is for athletes whose physical examination was completed 90 days prior to the first day of official practice.
Health History Update Questionnaire Form
Health Physical Form
Needed by the health office for health history updates. Completed by parent and student`s Physician or Advanced Practice Nurse (APN). Please attach immunization records.
OTC and Prescription Medication Form
This form is for prescription and Over the Counter (OTC) medications. Must be completed by parent and physician before medication can be administered at school by the school nurse.
OTC and Prescription Medication Form
Authorization for Administration of OTC Medication for Acute Illness at School
The school physician has authorized the administration of Tums, Ibuprofen, and Tylenol if needed with parent`s/guardian`s permission.