Melissa Singer, RN
School Nurse 
Tel: 355-5220
Fax: 355-5192

All medical forms submitted must be ORIGINALS, signed and dated by the physician.  Faxes may be received from Physicians

• Summer Health History Form
• Medical Updates
• Emergency Contact Update
• Current Health Exam Form for grade 7, and new students.

Please consult this FLU FACT SHEET to help prevent the spread of the flu.

Influenza – commonly known as the flu is a contagious illness that affects the nose, throat, lungs and other parts of the body and can spread quickly from one person to another, according to the New York State Department of Health (DOH). It can cause mild to severe illness and be fatal, especially for those age 65 and older. Across the United States, the flu causes about 12,000 to 56,000 deaths. About 90 percent of these deaths occur in people 65 years or older.

This season, there has been one influenza-associated pediatric death reported to the New York State DOH.

Please be aware of the following NYS Department of Health Immunization Requirements for ALL MIDDLE SCHOOL STUDENTS (GRADES 6-8):

• Diphtheria, Tetanus and Pertussis Vaccine (DTaP/DTP): 3 doses
• Polio Vaccine (IPV/OPV): 3-4 doses (See your doctor for individual dosing requirements.)
• Measles, Mumps and Rubella Vaccine (MMR): 2 doses
• Hepatitis B: 3 doses
• Tdap: 1 dose (Not required until the child is 11 years of age.)
• Varicella (Chicken Pox): 2 doses
• Meningitis: 1 dose (Not required until the child is entering 7^th grade.) 

Proof of immunization/immunity includes a vaccination record or a signed letter by your physician.

New York State law requires a health examination for all students entering the school district for the first time and in grades K, 1, 3, 5, 7, 9, and 11. The examination must be completed by a New York State licensed physician, physician assistant or nurse practitioner and on the approved NYSED Student Health Examination Form for School.

Health Exam Form

The MVCSD school medical examination consists of weighing and measuring, observation of general health, examination of nose, throat, skin, teeth, glands, muscles, joints, groin, abdomen, spine, posture, heart, and lungs.  The school nurse is present during examinations and will promptly advise parents of any potential problems discovered in this examination.

School Physical Permission Form

Students must have physician's orders for medication to be dispensed at school, for both prescription and OTC (over the counter) medications.  New York State allows only asthma inhalers, diabetic supplies, and Epinephrine auto-injectors to be carried with students in school.  The following form must be submitted to the nurse prior to bringing in any medication.  School law requires the following: Medication Form and Medication Provider Attestation Form

• Name of medicine
• Reason for giving
• Dosage
• Time
• Number of days to be dispensed
• The medicine must have a professional label.
• It must be brought to the Health Office / School Nurse by an adult.  Under no circumstances is a child to bring medicine to school.
• The parent or guardian must submit a written request to the school nurse to dispense the medicine as directed.
• The medication will be destroyed seven days after the final dosage is required.  The unused medication may be picked up by a parent/guardian within this period.
• All medications that are not picked up at the end of the school year will be destroyed.

Students must have a note from a physician in order to be excused from physical education class.  Note must include medical reason for excuse.  In addition, a physician's note is also required clearing the student to resume class.

• Students should be temperature free for 24-hours before returning to school after an illness.
• Students should have completed a 24-hour antibiotic cycle before returning to school.
• Contact the health office with any information about exposure to communicable disease and/or health problems

Please click the following link for information regarding New York State's Mandated Health Screening Guidelines.

If you suspect a child is being abused or maltreated (neglected), report it by calling 1-800-342-3720, a toll-free 24-hour hotline operated by the New York State Office of Children and Family Services. If you believe a child is in immediate danger, call 911 or your local police department. Information about reporting child abuse and maltreatment (neglect) is available online at http://ocfs.ny.gov/main/cps/