Health forms need to be submitted to the School Nurse for all students by August 1st to provide time for the nurse to review and request any additional information. 

• Prior to the start of the school year, students who are NEW or entering Pre-Kindergarten, and Kindergarten, MUST submit the COMMONWEALTH OF VIRGINIA SCHOOL ENTRANCE HEALTH FORM, including up-to-date immunizations.
• Students of all other grades must submit the CONFIDENTIAL STUDENT HEALTH HISTORY (English) ,  CONFIDENTIAL STUDENT HEALTH HISTORY (Spanish)  or CONFIDENTIAL STUDENT HEALTH HISTORY (Vietnamese) form prior to the start of the school year. 
• Seventh grade students need an updated immunization record.

NOTE: After your child completes his/her Annual Physical with their physician, ALL parents are asked to submit the COMMONWEALTH OF VIRGINIA SCHOOL ENTRANCE HEALTH FORM completed by your child’s pediatric office. Please annotate ALL medical conditions on medical forms for your student’s safety. 

If your student has medications that need to be taken at school, either for a short period of time, in case of emergencies, or for daily administration, please find the appropriate forms referenced below.  

• Food Allergy and Anaphylaxis Emergency Care Form
• Epipen – If your child requires an Epipen, these are the documents the physician needs to sign:
  Epinephrine Administration Form
  Allergy Action Plan
• Inhaler / Nebulizer – If your child requires an inhaler or a nebulizer, these are the required forms.
  Inhaler Administration Form
  Asthma Action Plan
• Allergy Medication – If your child requires allergy medication (not epinephrine), this is the form needed.
  Antihistamine Authorization Form
• Diabetes Medication – If your child has diabetic medications, please fill out these forms.
  Diabetes Medical Management Plan Form
  Diabetic Reference and Indemnification Form
• Medication Authorization Form – If your child needs other prescription medications or over-the-counter medications, this form will need to be completed. It can also be used for medications needed on a field trip that are not normally taken at school. This form is for medications such as, but not limited to antibiotics, dramamine, Tums, Ibuprofen products, Acetaminophen products, cough drops, calamine lotion, etc.
  Medication Authorization Form

If you have any questions, please contact Mrs. Jennifer Sullivan, school nurse, at jsullivan@allsaintsva.org.