Jr./Sr. High School Nurse
Allison Swift, NP

aswift@cooperstowncs.org
Phone: 607.547.2808
Fax: 607.282.1036

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 jr./sr. high school nurse.

Required Form for Health Examinations

Accident Report

Asthma Care

Baseline Concussion Screening

Bee Sting Allergy Care Plan

Bloodborne Pathogen Exposure Control Plan

Diabetes-Hyperglycemia Care Plan

Food Allergy Care Plan

Latex Allergy Care Plan

Medication Form

Religious Exemption Forms

Seizure Care Plan

Self Medication Release Form

ImPACT Testing

Opioid Overdose Prevention Training

Fuel up to Play 60

Fight Flu at Home and School

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

Medications in school, including over-the-counter, must be kept in the Elementary School Nurse’s Office and must be administered by the school nurse. Medications must be delivered by a parent in its original container, accompanied by written doctor’s instructions and parent permission.

ABSENT NOTES

Absent notes are required on the day a student returns to school after being out ill. Tardy (arriving late to school) and early dismissal notes should be sent in that day. Out-of-town or vacation excuses should be sent in prior to leaving.

HEALTH SCREENING

Health examinations will be required for new entrants and in grades Pre-K or K, 1, 3, 5, 7, 9, and 11. This is the form required for Health Examinations.

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

• Three doses of Polio

• 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 if 7 years of age or older and the series started at age 1 or older)

• Two doses of Measles/Mumps/Rubella

• One dose 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, grade 7, 8 and 9. 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.

• Three doses of Polio grades 11-12.

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