Mrs. Erin Giarrusso
973-543-7107 ext 221
Permission Form for Administration of Medication
Form to be completed annually
- Permission for School Nurse Administration of PRESCRIPTION MEDICATION (FORM H 4)
Screening Exemption Form
Form to be completed annually
-Health Screening Exemption Form (FORM H 3)-ANNUAL RENEWAL REQUIRED
Sports Related Eye Injury Fact Sheet
(FORM A 6) (read only)
Opiod Use and Misuse Information and
SIGN OFF SHEET (requires signature)
- The Mendham Township Board of Education forbids any student from carrying any medication
(OTC or prescription) without the knowledge and consent of the administration and school nurse.
Medication shall include all medicines prescribed by a physician, including emergency medications,
i.e., inhalers and Epi-pens, and all non-prescription OTC medication.
- For the students' convenience, we will stock regular-strength and Jr. strength Tylenol (acetaminophen), Advil (ibuprofen), Pepto Bismol, and Tums, but we will still need written permission to administer them. This can be done on the yearly emergency information form. Any other OTC medication shall be brought to school in the original, sealed container, and labeled with the student's name. All medication is to be taken home by the parent when it is no longer needed, or at the end of the school year.
- Prescription medication shall be brought to school by the parent, unless other arrangements have been made with the nurse. It must be in the original prescription container, and labeled with the name of the student, medication, dosage, and name of the physician.
- Vision, Hearing, Height, Weight and Blood Pressure are monitored yearly.
- Parents are notified if a significant problem is noted.
- Scoliosis screenings are done bi-annually for 5th and 7th graders in the spring. Letters are sent home approximately 1 month prior to screening, you may choose to exclude your student from this screening. Please use the link below to exempt your child from these screenings:
Screening Exemption Form (must be completed annually) Screening Exemption Form
a healthy weight through activity and good food choices.
social health issues from infancy through young adulthood. An important resource for
parents/guardians who may have questions about specific health, social, or developmental concerns.
wellbeing. This site provides current information on almost any health and safety topic
as well as publications and products.
institutes and centers which make up the National Institutes of Health (NIH) and provide
helpful information and fact sheets concerning medical conditions and achieving optimal health.
Covers a wide range of health topics.
district policies concerning health services.
tracking dietary intake and exercise progress. MyPlate has replaced the MyPyramid program.
the US. Provides information for parents/guardians, students, and healthcare professionals.
A great resource for all your diabetic questions.
section on children's health.
professionals. Site includes cancer facts, treatment options, support services, and a bookstore
as well as other useful features.
provides information about managing food allergies in childcare and school settings. Has
seperate teen and kid specific web sites.
sections on coping with allergies and asthma in the home, childcare, and school settings.
Provides useful information in regards to pets, play time, and shopping.
The following guidelines must be used when determining if your child should be kept home from school:
- Common Cold - Your child may return to school when the severity of the symptoms subsides
and the temperature has been normal for 24 hours without medication.
- Ear Infections - Your child may return when pain free and the temperature is normal.
- Fever - Your child may return when their temperature has been normal for 24 hours without medication.
- Lice - If your child has lice. Parent(s)/Guardian(s) must treat the child’s hair
(contact your doctor for further instruction), and remove the lice eggs from the hair.
- Pink eye - Your child may return after being on medication for 24 hours.
- Pneumonia/Bronchitis - Consult your physician.
- Strep Throat - Strep is not contagious after 24 hours on appropriate medication. I suggest that you
keep your child home for 48 hours as a matter of good health practice. Always remember to replace
your child's toothbrush after a strep infection.
- Vomiting/Diarrhea/Flu - Your child may return after there has been no vomiting or diarrhea and is
fever free for 24 hours.
requires that they be excused from activity in physical education, a physician’s order MUST be sent
to the nurse and will be given to the PE teacher. It is expected that any child who has restricted activity in physical education will have restricted activity at recess. We need to be certain that any student who is recovering from an injury or illness is safe at school.
- Please check the middle school calendar for deadlines for sports physicals/paperwork, seasonal sports sign ups and tryout dates.
- Student's eligibility for tryouts is determined by a current sport physical on record in the health office before tryout day. (A current physical means that a student has had a physical within 365 days prior to the tryout date and a completed state mandated form is on record for the student in the health office.)
- The 90 Day Health History update form is a NJ state requirement and is necessary if the date of the physical on file is over 90 days from the first day of tryouts.
- Students who do not have this paperwork in the health office by the sports calendar deadlines WILL NOT BE ELIGIBLE FOR TRYOUTS!! NO EXCEPTIONS WILL BE MADE!!
- Please call the health office, 973-543-7107 ext. 221, if you are unsure of your child's eligibility.
Forms Required for Athletic Participation
- Athletic Participation Physical Examination Forms (FORM A 1) (REQUIRED for athletic participation / grades 6-8 ONLY)
- 90 Day Health Update Form for Athletics - Parent to complete (FORM A 2) (required if physical is dated more than 90 days prior to first sports practice)
- Concussion Head Injury Fact Sheet (FORM M 4) (requires signature)