- Authorization for Use or Disclosure of Protected Health Information
- BMI Opt Out Form
- Health Examination Form
- Medical Information & Emergency Form
- Permission to Administer Medication
Hornell City School District Health Services Guidelines
1. School Physicals: A physical is necessary for all students entering into public schools as mandated by New York State for the following: All new entrants, Pre K, K, 1st, 3rd, 5th, 7th, 9th and 11th grade students. If your child has had a physical within a year of the first day of entering please be sure to provide a copy to your school nurse. Physicals are to be done by a physician licensed to practice in New York State and shall include BMI (body mass index) and WSC (weight status category) information, which will be reported to NYS without the use of names. Parents may opt out of having their child’s WSC reported to NYS by signing an “opt out” request and returning it to the respective school health office.
2. Immunization record: An Official immunization record from a physician’s/public health office is required for entry in NYS schools. This record must be produced within 14 calendar days o admission to school, 30 days if coming from out of state.
New York State Department of Health requires that each student comply with the following immunization requirements; HIB-Pre-K 1-4 doses, PCV – Pre-K 1-4 doses, DTP-PrekK,4 does, grades K-6- 5 does or 4 if the 4th dose given at 4 years of age or older grades 7-12- 3 odes, Polio-Pre-K-3 doses, grades K-12- 4 doses or 4 if the 3rd dose was given at 4 years or older, MMR- Pre-K 1 dose, K-12- 2 doses, Hepatitis B Series- 3 doses, Varicella (Chicken Pox)- Pre- K and 12th – 1 dose, 2 doses for all others, TDAP- 1 dose for all students entering grades 6-12. ALL STUDENTS ENTERING GRADES 7-12 MUST HAVE THE MENINGOCOCCAL VACCINE, 12TH graders must have two doses unless the first dose given was at or after the age of 16. THEY CANNOT START SCHOOL WITHOUT IT. Again, if you have already provided proof of this to the school nurse, than you, nothing further needs to be done.
3. Hearing, Vision and Scoliosis: The school nurse will do vision and hearing screening for all new students as well as students in grades Pre-K, K, 1, 3, 5, 7, 11 and upon request. Scoliosis screenings will be done for girls in grades 5 & 7 and boys in grade 9, any abnormal finding will be reported to the students; parent/guardian.
4. Physical Education Restrictions: NYS requires that all students participate in physical education. If your child has an illness or injury which prevents them from performing normal activities, please ask their physician to document what they can do safely and bring the note to the nurse’s office. When our child can return to normal activities a written release from the doctor is also required to be brought in.
5. Medication: Any medication that must be taken during school hours including over the counter medications, must be brought to the nurses’ office in its original container with the label intact. A parent should bring the medication to school with a permission form signed by the physician and the parent. The medication will be kept in the nurses’ office and administered at the proper time.