Health Forms & Documents
Health Services
The school health program is designed to give first aid and medical care for injuries and illnesses that occur primarily during school hours.
In addition to providing emergency care, school nurses perform health screenings for all students and also provide support for those with special needs. Education and wellness promotion is a major focus of our program. Please remember that the nurse’s office is not a primary care facility. School nurses cannot diagnose, prescribe treatment, or give medications without a doctor’s order.
School Health Screenings
School health screenings in the state of Pennsylvania include mandated yearly measurement of your child’s body mass index (BMI). BMI is a screening tool used to determine whether a child is overweight or underweight. Your child’s BMI is based on the ratio of height to weight and reported as a percentile ranking based on the child’s age and gender. The Centers for Disease Control (CDC) created the percentile ranges, listed below, to identify children who may be at risk for specific health problems. Children with high BMI are at increased risk for serious health conditions such as insulin resistance (a precursor to diabetes) and heart disease. Like all screening tools, BMI can produce some false positives or false negatives. For example, a student may have an artificially high BMI due to a high level of lean body tissue or muscle, as may be found in a well-conditioned athlete. Your child’s health care provider is in the best position to evaluate your child’s overall health.
Underweight = <18.5 Normal weight = 18.5–24.9 Overweight = 25–29.9 Obesity = BMI of 30 or greater
Epinephrine Auto Injectors
In compliance with Board Policy 200, all MTSD buildings maintain a supply of epinephrine auto-injectors or epi-pens. The school nurse at each building maintains the emergency stock epinephrine auto-injectors that are prescribed by the school physician and available in case a student has an emergency allergic reaction while at school. If your child should experience an anaphylactic reaction while at school, the nurse would utilize the epi-pen auto injector as part of an emergency response protocol.
All parents have the right to opt out of the provisions of this policy. If you want to opt out of this policy you can do so by completing the “opt-out” form. This form can be obtained by calling your school nurse. Your school nurse would also be able to answer any questions about the emergency epinephrine auto injectors.
Documentation
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- Adapted Gym Form (114.901 KB)
- Dental Exam Form (602.521 KB)
- Notification of Required Medical Exam (78.275 KB)
- Physical Examination Form (217.36 KB)
- Student Health History (551.421 KB)
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- New School Vaccination Parents Required Vaccinations (2.185 MB)
- Allergy School Action Plan (214.101 KB)
- Asthma School Action Plan (142.598 KB)
- Immunization Information
- Medication Authorization (244.524 KB)
- Seizure School Action Plan (195.31 KB)
- Parent Guardian Sunscreen Form (444.029 KB)
- Student Sunscreen Form (444.002 KB)
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- Physicals are required in grades K, 6, and 11. Private physicals are preferred. If you do not provide a private physical, a school physical (at no cost to you) will be scheduled.
- Dentals are required in grades K, 3, and 7. Private dentals are preferred. If you do not provide a private dental, a school dental (at not cost to you) will be scheduled.
- Your student entering seventh grade will require proof of having had the immunizations Tdap and MCV on the first day of school.
- Your student entering grade 12 will require proof of a second MCV vaccine by the fifth day of school.
- If your student has a chronic health condition, please complete the appropriate Health Action Plan found on this webpage or contact your school nurse.
- Please remember, a new Authorization for Medication form is required each school year. The form can be found on this webpage.
