Health Forms

New students for the 2019-2020 school year will be available in our Student Health Information System, Magnus Health, in early July.  Parents will receive an email with details on how to access Magnus and upload their child's forms.

If you are planning a doctor's visit for your child's annual check up and would like to get these forms out of the way, we encourage you to do so. The required forms are linked below; those that require a doctor's signature are noted below.

Retain a copy of any completed forms and upload them when prompted to do so.

All forms are due by July 26, 2019.

Questions? Contact Gina Polidoro, School Nurse.

Student health forms

DC Universal Health Certificate

DC Immunization Record

Maryland immunization records are also accepted.

DC Oral Health Assessment Form

To be completed by the child's dentist within 365 days of the start of school.

Prescription Medication Authorization Form 

To be completed by the child's parent AND physician for EACH prescription medication to be administered at school.

If your child will be taking prescription medication during the school day, a Prescription Medication Authorization form signed by a physician must be provided. See Parent Handbook for additional requirements for prescription medication, or contact the school nurse for guidance.

Over the Counter Medication Authorization Form

To be completed by the child's parent AND physician.

If you would like over-the-counter medications to be made available to your child during the school day, please provide an Over The Counter Medication form signed by a physician. These medications are school-provided, except any additional medications specified in the “other” column.

Food Allergy & Anaphylaxis Emergency Care Plan

To be completed by the child's parent and physician.

Asthma Action Plan

To be completed by the child's parent and physician.

Seizure Action Plan

To be completed by the child's parent and physician.

HPV Vaccination Opt-Out Form (Ages 11+)

Boys and girls age 11 or older or entering 6th grade are required to have the HPV vaccination series. If do not wish for your child to start the HPV vaccination series recommended for this age group, please complete the HPV Opt-Out waiver. Evidence of starting the vaccination series OR a parent-signed waiver is required by the DC Department of Health.