William Floyd Elementary
John S. Hobart Elementary
Tangier Smith Elementary
Nathaniel Woodhull Elementary
William Floyd Learning Center
William Paca Middle School
William Floyd Middle School
High School East A-L
High School West L-Z
Medical Forms and Documents
Sports Physical Form
Student Emergency Card (Eng)
Student Emergency Card (Sp)
Students Entering 6th & 7th
Activity Form (Elementary)
Activity Form (Secondary)
Health Education opt-out form
BMI Survey opt out letter
Health Appraisal (Physical)
Medication Order Form
Self-Medication Order Form
Request for Internal Medication
Per New York State Education Law, additional vaccines will be required for students in September 2019:
- Meningococcal vaccine (MCV4) will be required for all students in grades 7, 8, 9 and 10. A booster will be required at age 16
- Meningococcal vaccine (MCV4) that was administered on or after the student’s 16th birthday will be required for all 12th graders
- Students in grades 6 to 12 must provide proof of a Tdap vaccine. Students who are entering 6th grade and who are 11 years of age or older must receive a Tdap vaccine (Tetanus toxoids, diphtheria, and acellular pertussis). Students who are 10 years old and entering 6th grade will not be required to receive the Tdap vaccine until they turn 11 years old. At that time they must provide documentation of the Tdap.
- An additional polio vaccine may be required for students in grades 6 through 11, depending on the intervals of previously received vaccines. Your child’s school nurse will advise you if another dose is required.
- An additional DTP vaccine may be required for students in grades K through 5, depending on the intervals of previously received vaccines. Your child’s school nurse will advise you if another dose is required.
A second varicella (chicken pox) vaccine is required for all students in grades K through 11.
All New York State public school students must have a health exam when they enter school as a new entrant and in Pre-K or Kindergarten and grades 1,3,5,7,9 and 11. These examinations must be completed on the approved NYSED Student Health Examination form for School for the health exam. If a private health care provider physical is not received within 30 days of the start of school, New York State Law mandates that the student be seen by the school physician.
Please note that students who have not received the vaccine(s) cannot be cleared to participate in interscholastic sports. Please make sure your child is compliant with this new vaccine requirement to submitting athletic paperwork for sports clearance.
If you have questions or concerns about immunizations, please contact your child’s school nurse.
Student Health Important Information
If your child’s health status changes during the course of the school year, it is IMPORTANT that you notify his/her school nurse so that we can accommodate any health needs that may arise. Please contact the nurse if your child begins or stops taking any medications, has surgery, or is diagnosed with any health condition.
All students who are entering 6th grade in September and are 11 years old by September 1st will require a Tdap vaccine before they will be allowed to start. If your child has already received the vaccine, please submit proof to his/her school nurse as soon as possible to avoid delay in approving your child to start 6th grade. If your child has not yet received the shot, please be advised that proof of vaccine must be submitted to the middle school nurse prior to the first day of school in order for your child to be able to begin 6th grade classes. Please contact the school nurse if you have any questions regarding this matter. Thank you
Effective July 1, 2018, New York State Education Law requires a medical examination of children on entrance to school and at Pre-K or K (if student did not attend Pre-K in one of our buildings), and grades 1, 3, 5, 7, 9 and 11. While a school physical is available to students in these grades, we believe it is in the best interest of your child’s health to have this examination performed by your family physician who has the history available and is able to administer the necessary immunizations. The forms for private physicals are available in each school’s nurse’s office and on the website under the section Student Health. An annual medical examination is recommended for all adults.
Medication During School Hours
Medication may be administered during school hours only under the following conditions:
- The parent may come to the health office with the medication and give it to the child at the appointed time.
- A written prescription from the doctor has been received by the nurse, a written statement from the parent requesting administration of the medication is on file, and the medication is in a properly labeled original container. This rule also applies to non-prescription medications. Parents must pick up all unused medication before the last day of school or it must be discarded.
New York State Public Health Law, Section 2164, requires that children attending public schools must be immunized against polio, diphtheria, tetanus and pertussis, measles mumps and rubella, hepatitis B vaccine, and varicella (chicken pox) vaccines. All students in grades K-4 and 6 – 10 must have 2 varicella vaccines. In addition, all students entering 6th grade who are at least 11 years old must provide proof of a Tdap booster. If the child enters 6th grade at the age of 10, he/she must receive the shot when he/she turns 11. All students in grades 7 through 12 must also submit proof of a Tdap booster.
Children (up to their fifth birthday) enrolled in the pre-kindergarten program are required to show proof of immunization against Haemophilus influenza type b (Hib) and the Pneumococcal Conjugate Vaccine (PCV).
In addition, all students in grade 7 will require a Meningococcal conjugate vaccine (MenACWY). All students in grade 12 will also require a MenACWY vaccine given after their 16th birthday.
Please be aware that New York State frequently revises the immunization requirements for school attendance. The school nurses will advise parents if their children require additional immunizations to comply with the new regulations. All physician immunization records must be signed and stamped.
NEW! For a list of immunization requirements from Pre-Kindergarten through 12th grade, CLICK HERE