Health Form Requirements and Downloads 

All required health forms are due to the Health Office by August 1st.  All forms are available to download and are highlighted in blue. Please see below for requirements by grade and optional forms for both NEW and RETURNING students.

All NEW Pre-K students:
The following forms are required. Please see additional optional medical forms at the bottom of this page.
PreK Health Inventory (Part 1 is completed and signed by the parent and Part 2 must be signed by a physician.)
I-896 Immunization Record
Blood Lead Testing Certificate
Over the Counter Medication Form (Must be signed by PARENT AND PHYSICIAN if you wish to authorize the administration of over-the- counter medications when your student visits the Health Office. No over-the-counter medication will be given without this documentation. Only a parent signature is required if you indicate that you do not authorize the administration of over-the-counter medications.)
Additional Forms – please scroll to the bottom of the page for the Food Allergy Action Plan, the Asthma Action Plan and the Medication Order Form (for administration of routine or prescribed medications during the school day) if such forms are relevant for your child.

All NEW students Kindergarten through 8th Grade:
The following forms are required. Please see additional optional medical forms at the bottom of this page.
Health Inventory (Part 1 is completed and signed by the parent and Part 2 must be signed by a physician.)
I-896 Immunization Record (please note that for students entering 7th grade, one dose of Tdap Vaccine and the Meningococcal Vaccine are both required.)
Over the Counter Medication Form (Must be signed by PARENT AND PHYSICIAN if you wish to authorize the administration of over-the- counter medications when your student visits the Health Office. No over-the-counter medication will be given without this documentation. Only a parent signature is required if you indicate that you do not authorize the administration of over-the-counter medications.)
Additional Forms – please scroll to the bottom of the page for the Food Allergy Action Plan, the Asthma Action Plan and the Medication Order Form (for administration of routine or prescribed medications during the school day) if such forms are relevant for your child.

ALL Returning 1ST through 8TH GRADE Students

Over the Counter Medication Form  Must be signed by PARENT AND PHYSICIAN if you wish to authorize the administration of over-the- counter medications when your student visits the Health Office. No over-the-counter medication will be given without this documentation. Only a parent signature is required if you indicate that you do not authorize the administration of over-the-counter medications.

ALL returning KINDERGARTEN students:
The following forms are required. Please see additional optional medical forms at the bottom of this page.
Health Inventory (Part 1 is completed and signed by the parent and Part 2 must be signed by a physician.)
I-896 Immunization Record
Over the Counter Medication Form  (Must be signed by PARENT AND PHYSICIAN if you wish to authorize the administration of over-the- counter medications when your student visits the Health Office. No over-the-counter medication will be given without this documentation. Only a parent signature is required if you indicate that you do not authorize the administration of over-the-counter medications.

ALL Returning 6th Grade Students
A new physical is HIGHLY recommended for students entering Middle School.
Health Inventory (Part 1 is completed and signed by the parent and Part 2 must be signed by a physician.)

ALL Returning 7th Grade Students
Additional Immunization Requirement for new and returning 7th Grade Students: All 7th grade students must have one dose of Tdap Vaccine and the Meningococcal Vaccine. Please verify with your physician that this immunization has been administered, or make an appointment for your rising 7th grader to receive it, and submit the updated immunization record into the enrollment portal or in hardcopy form to the Health Office. 

ADDITIONAL Forms for Pre-K3 through 8th Grade NEW and RETURNING Students

Students requiring medication during the school day:
Medication Order Form (routine or prescribed medication)
No routine or prescribed medication can be administered to a child without proper documentation on file in the Health Office. Please submit documentation by August 1st and bring the medication to the health office prior to the first day of school.

Students requiring plans for special medical needs:
Asthma Action Plan Form
Food Allergy Action Plan Form

Any questions or concerns, please call 410-427-4812 or email nurse@theimmaculate.org during school hours.