The following information is provided to assist in caring for the health of each of our students. If you have any questions for our School Nurse, please contact Mrs. Katie Nowakowski, RN, at 703-368-4400 or email@example.com.
Important Information for ALL Families for August 2023
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 HEALTH HISTORY 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.
NOTE: ALL medications must be hand-delivered by an adult to the school nurse with the associated form completed and signed. Students are not allowed to self-carry medications in elementary school, with a few exceptions by permission of their physician.
- 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.
Medication Authorization Form
If you have any questions, please contact Mrs. Katie Nowakowski, the school nurse, at firstname.lastname@example.org.
Physical & Immunization Requirements
- Completion of the Commonwealth of Virginia School Entrance Health Form (fillable pdf version) required for all Pre-Kindergarten, Kindergarten, and Transfer students. The Health Form must be completed and on file in our school office prior to the start of the new school year.
- Virginia has passed legislation requiring additional vaccinations for school admittance effective July 1, 2021. Required Immunizations by the Virginia Department of Health can be found on Supplemental Guidance for School Required Vaccines.
NEW Vaccines Required Prior to 7th Grade:
- Meningococcal Conjugate (MenACWY) Vaccine
- Human Papillomavirus (HPV) Vaccine at the parent’s or guardian’s sole discretion, may elect for the child not to receive the HPV vaccine.
- Diphtheria, Tetanus, & Pertussis ( Tdap)
NEW Kindergarten Vaccine Required Prior to School Entry
- Hepatitis A
Health Resources and Links
Type 1 Diabetes: