Important Forms

  • Important 2020-21 Information - Regardless of whether students participate in remote or in-person learning, physicals and immunization requirements must be fulfilled per the NYSDOH guidelines. 

    On 6/13/19, an amendment to public health law section 2164 passed which eliminates the exemption from vaccinations due to religious beliefs for school attendance. Please see the attached information and guidance from the New York State Department of Health. 
    Please contact your primary care provider to verify if your immunizations are up to date and schedule appointments accordingly. You can also contact the Wyoming County Health Department to schedule appointments for vaccination at (585) 786-8890. 

    Health Examination Form
    Health exams are required for all students in grades Pre-K, K, 1, 3, 5, 7, 9 and 11, as well as all new entrants and students who want to participate in school sponsored sports. 

    Dental Certificate- OPTIONAL 

    Medication Authorization Forms
    To protect the health and safety of all students, schools must have a written provider order and written parent/guardian consent in order for a student to be administered a medication, or to permit a student to self-administer their medication at school. A provider order is required for both prescription and non-prescription medications. A provider order is valid for 12 months, unless the provider changes the order, writes the order for a shorter period of time, or discontinues the order.

    Medication Attestation Form 
    For independent medication carry and use of RAPID ADMINISTRATION MEDICATIONS  (Epi-Pens, Inhalers & Diabetes Medications)

    Screening Guidelines
    Your child will be screened by the school nurse during the school year for vision, hearing and scoliosis, and is required by NYS Law. If the Health Office has a current physical on file and the physician has performed the required screening, the nurse does not need to screen your child. 

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