Melissa Singer, RN
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.
Health Exam Form
Emergency Contact Update
BMI Opt-Out Form
MVCSD has been selected to report information on student Weight Status Category (BMI) for the current school year. Data will be collected from grades 1, 3, 5, 8 and 11.
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.
Please be aware of the following NYS Department of Health Immunization Requirements for all middle school students (GRADES 6 to 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 7th 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, testes, 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.
Students must have a physician’s orders for medication to be dispensed at school, for both prescription and OTC (over the counter) medications. School law requires the following:
Medication Log Form
Name of medicine
Reason for giving
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.
New York State allows only asthma inhalers, diabetic supplies, and Epinephrine Auto-injector’s to be carried with students in school. The following form must be submitted to the nurse prior to bringing in any medication.
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.
School Health Guidelines
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
The district’s School Health Services program supports your student’s academic success by promoting health in the school setting. One way that we provide care for your student is by performing the health screenings as mandated by the State of New York.
During this school year, the following screenings will be required or completed at school:
● Near vision acuity and distance acuity for all newly entering students and students in Kindergarten, Grades 1, 3, 5, 7, and 11.
● Color perception screening for all newly entering students.
● Hearing screening for all newly entering students and students in Kindergarten, Grades 1, 3, 5, 7 and 11.
● Scoliosis (spinal curvature) screening for girls in grades 5 and 7 and for boys in grade 9.
● A physical examination including Body Mass Index and Weight Status Category Information is required for all newly entering students and students in Kindergarten, Grades 1, 3, 5, 7, 9 and 11.
● A dental certificate is requested for all newly entering students and students in Kindergarten, Grades 1, 3, 5, 7, 9 and 11.
A letter will be sent home if there are any findings on the screening done at school that would cause concern or need medical follow-up. Please call the school’s Health Office if you have any questions or concerns.
Child Abuse Hotline Notification
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 https://ocfs.ny.gov/main/cps/