Student Registration Health Forms
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In order to register your child for school, you must present the following:
Immunization Records
Immunization records certified by your healthcare provider documenting the day, month and year, each required immunization was received. The immunization records must be in English. See Immunization Requirements below for a list of immunizations required by the State of New Jersey.
Universal Child Health Record
All students entering school for the first time are required to provide documentation of a physical examination. The physical examination must be dated within 365 days of your child’s first day of school to be accepted for registration.
Health Forms
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24 Hour Rule
In an effort to keep germs out of school, the District asks that you follow the "24 Hour Rule". Please read the attachment describing the exclusion time from school for the most common communicable diseases. Please call the Health Office if your child is diagnosed with a communicable disease. The nurse keeps a record so that they can monitor the number of cases of a particular disease and they send home notices to alert parents.
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Allergic Reaction - Parent Authorization
This form is to be completed by the parent/guardian indicating whether or not the student is capable of self-administering emergency medication. This form also has a section for parents/guardians to authorize a trained designee to administer emergency medication in the absence of the school nurse.
09-Emergency Treatment of an Allergic Reaction - Parent Authorization.pdf 12.85 KB (Last Modified on February 26, 2016) -
Allergic Reaction - Parent Contact Information
This form is to be completed by the parent/guardian giving current emergency contact information This form also has a section for parents/guardians to authorize emergency medical treatment for their child.
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Allergic Reaction Action Plan
This form is to be completed by the healthcare provider when a student requires emergency medication for an allergic reaction.
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Asthma Action Plan for Home and School
This form is to be completed by the healthcare provider. There is a section at the bottom where the healthcare provider must indicate whether or not the student is capable of self-administering his/her asthma medication in the absence of the school nurse.
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Flu Information
The attachment reviews key facts about the flu. This information may be helpful. For more detailed information, you can visit the Center for Disease Control (www.cdc.gov) or the American Academy of Pediatrics (www.aap.org) web sites or contact your physician.
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Health Services Agencies
For residents of Mercer County who are in need of receiving medical care, but do not have adequate health insurance, the attached list of agencies may be able to provide care at a reduced fee or no cost.
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Immunization Requirements
This is a list of immunizations required for all students to attend school in New Jersey. Immunization records need to be submitted to the Health Office for review BEFORE your child can start school.
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Physical Form (Universal Child Health Record)
The Board of Education requires all students new to the District to have a physical examination. The Universal Child Health Record form is to be completed by your child's physician. Physical examinations must be done no more than 365 days prior to school entry to be accepted for registration. Please make sure the date of the physical exam is specified by your physician.
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Policy Regarding the Administration of Medication in School
Reviews policy & procedures when medication is required in school, on field trips or at school-sponsored events.
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Request for Administration of Medication
This form must be completed by the physician for daily medications including over-the-counter or short term medications, such as antibiotics and cough medicine.
03-Request for Administration of Medication in School.pdf 112.08 KB (Last Modified on February 26, 2016) -
School Seizure Action Plan (SAP)
Seizure Action Plans help organize seizure information and have it available when it is needed mostt. A prepared plan can help know what to do to prevent an emergency orinform other what to do in the event of a seizure.