Elementary School Nurse
Kim Stahl, RN BSN
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Phone: 607.547.9322
Fax: 607.547.4427

Junior-Senior High School Nurse
Thomas Molloy, RN
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Phone: 607.547.2808
Fax: 607.547.5100

For assistance accessing, reading or completing any of the forms below or to receive a printed copy of any of these forms directly from the school, please contact the appropriate building-level nurse.

Required Form for Health Examinations

Accident Report

Asthma Care

Bee Sting Allergy Care Plan

Bloodborne Pathogen Exposure Control Plan

Diabetes-Hyperglycemia Care Plan

Food Allergy Care Plan

Latex Allergy Care Plan

Medication Form

Seizure Care Plan

Self-Medication Release Form

Student Health History Form

BMI Parent Letter

When to Keep a Child Home With Illness

Conjunctivitis

Opioid Overdose Prevention Training

Preventing Tick Bites

Removing a Tick

Healthy bodies lead to healthy minds and a school nurse plays an important role in education.

Medications in school, including over-the-counter, must be kept in the nurse's office and must be administered by the school nurse. Medications must be delivered by a parent in their original container, accompanied by written doctor’s instructions and parental permission to administer.

HEALTH SCREENING

Health examinations will be required for new entrants and in grades Pre-K or K, 1, 3, 5, 7, 9, and 11. The required NY state form is listed on the left.

SCOLIOSIS SCREENING

Scoliosis screening will be required in grades 5 and 7 for girls and grade 9 for boys

VISION SCREENING

Vision screening for color perception, distance, and near vision acuity will be required for new students within 6 months of admission to school. Distance and near vision acuity will be required in grades Pre K or K, 1, 3, 5, 7, and 11.

HEARING SCREENING

Hearing screening utilizing pure tone testing will be required for new entrants within 6 months of admission to school and in grades Pre K or K, 1, 3, 5, 7, and 11.

Parents will be notified about failed screenings.

Section 2164 of the New York State Public Health Law requires that students receive certain immunizations to enter a specific grade level and attend school. Listed below are the required vaccinations by grade level:

Students in Kindergarten and Grades 1-4

• Four doses of Polio (or 3 if 3rd dose at 4 years of age or older)

• Three doses of Hepatitis B

• Five doses of Diphtheria/Tetanus/ Pertussis (or 4 if the 4th dose given at 4 years of age or older or 3 doses if 7 years of age or older and the series started at age 1 or older)

• Two doses of Measles/Mumps/Rubella

• Two doses of Varicella (Chickenpox) or physician certification of disease.

Students in Grade 5

• Four doses of Polio (or 3 if the 3rd dose was given at 4 years of age or older)

• Three doses of Hepatitis B

• Five doses of Diphtheria/Tetanus/ Pertussis (or 4 doses if the 4th dose given at 4 years of age or older or 3 doses if 7 years of age or older and the series started at age 1 or older)

• Two doses of Measles/Mumps/Rubella

• Two doses of Varicella (Chickenpox) or physician certification of disease.

Students in Grades 6-12

• All students are required to have had a least one dose of Tdap

• Three doses of DTaP/DTP

• Two doses of Measles/Mumps/Rubella

• Three doses of Hepatitis B vaccine (or 2 doses of adult Hepatitis B (Recombivax) for children who received the doses at least 4 months apart between 11 through 15 years of age)

• Meningococcal vaccine One dose in grades 7, 8, 9, 10 and 11. Grade 12 two doses or one dose if received at 16 years of age or older.

• Two doses of Varicella vaccine, grades 6-10 or one dose grades 11-12.

• Four doses of Polio grades 11-12 (or 3 doses if the 3rd dose was given at 4 years of age or older).

Students who have not received, and are not in the process of receiving, such immunizations shall not be permitted to attend school.

Please contact your child's school nurse for more information and immunization schedule for in process.