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2018-2019 Health Forms
Required Health Forms & INFORMATION -- ALL STUDENTS 2018-2019

To print the information below, click on the download here:  Required Health Forms for all students

**ALL Students—Every Year
New Electronic Parent form and Paper Physician form
Due by August 1st**


Looking forward to the new school year, the following health forms are required to be submitted to the school nurse by August 1st for students to be able to start school, participate in any school activities, or try out for an athletic team. For the 2018-19 school year, physical exams are required to be performed every 12 months, with a new form submitted when it expires--either in spring, summer, or during the school year (see explanations below about the physical exam dates). Parents may access all electronic and print all paper forms by logging onto PrepNet on the NDP website and navigating to the Athletic tab. More health information, without logging onto PrepNet--the physical and medication paper forms, and list of sports physical sites---may be found on this Athletic tab by clicking on “18-19 Health forms”. Electronically completed forms do not need to be printed and submitted once they are completed online.


Student Health Assessment and Consent Form (ELECTRONIC—parent completes every year-due Aug 1st--ALL STUDENTS):

  1. Form is available on the NDP website after July 6th
  2. Click on all tabs at the top of each page, complete each section, click next and e-sign when prompted. There are a few places to e-sign (participation, treatment, waiver consents), so please complete all sections.
  3. After the form has been submitted, any changes to a student’s health should be emailed to the school nurse.

Student Physical and Medication Form  (PAPER--print; physician completes; returning students due every 12 months; new students due by August 1st)

  1. New Students—Due by August 1st is a physical form with exam date that is less than 12 months old. A new physical exam, with NDP form, is due to the school nurse when this expires in 12 months (spring, summer OR during the school year).
  2. Returning students--Due every 12 months. Physicals on file in the nurse’s office, are active for 12 months. This means that for the 18-19 school year, it may not necessarily be due by August 1, 2018, unless the previous exam was before August 1, 2017. (ex. November 15, 2017 exam expires November 15, 2018, April 4, 2017 exam expires April 4, 2018, etc.)
  3. Important—All Students—beginning with the next school year 19-20 and due by August 1st: All physical exams will be required for 19-20 to be performed between May 1st -August 1st, with all forms due by Aug 1st to cover the whole school year. For this current school year 18-19, it is an option--not a requirement, but for the next school year 19-20, it is a requirement. If your daughter is not already on a spring/summer (May 1-August 1) exam schedule, it is a suggestion for this spring/summer 2018, to begin transitioning to having exams during this time frame. If not this spring/summer, then definitely by next May 1-August 1 2019. See suggestion below to transition to this exam schedule.
  4. Suggestion: To transition to May-August 1 exam dates—Since insurance allows exams only every 12 months, a “one time-out of pocket sports/camp/pre-participation physical” ($25-$35) may be done at one of the sites that offer this service (Patient First, TSM, CVS, etc.) to transition your daughter back to having annual exams during this required May 1-August 1 time frame, with her personal physician. Print and bring the NDP physical form to all appointments.


MD State Immunization form-MDH 896 (PAPER—print OR copy of physician record w/ exam—NEW studentsby August 1st)

  1. If Religious Exemption—PARENT prints and signs where indicated at the bottom where indicated on the form.
  2. If Medical Exemption—Parent prints form. PHYSICIAN states the medical reason and signs as indicated on the form.

XLNT Brain Sport: (ELECTRONIC—student completesoption for all students—required for ALL ATHLETES by 8/1)

* PASSCODE: NOTRE DAME PREP ATHLETE

  1. Available on the NDP website after July 6th.
  2. Go to XLNTbrain.com, click "Sign Up" and enter the passcode above to begin your registration.
  3. Click "Join as an Athlete" after you complete your registration, and then follow these steps:
    1. View concussion awareness video and pass brief video quiz
    2. Update profile info & accept terms and conditions
    3. Manage your teams * Take the XLNTBrain Baseline Test

Submission of forms: Paper forms listed above are to be delivered, mailed, emailed or faxed to NDP by August 1st to the attention of Ms. Kim DeMario, RN, School Nurse, demariok@notredameprep.com, fax 443-921-2890. Please contact the school nurse with questions. Ms. DeMario will respond to messages and email weekly over the summer. For questions about the XLNT Brain test, please contact Ms. Kristin Brown, Licensed Athletic Trainer, at brownk@notredameprep.com.
 

To print this information, download the document here:  Required Health Forms for all students

Illness & Injury Policy -- for All students

To print the information below, download the document here:  Injury & Illness Policy for all students

Health Suite

  • A registered nurse is on duty 7:45 a.m.-3:15 p.m. daily. After first notifying her teacher, a student is permitted to go to the Health Suite. In case of an accident, the student must be sent to or report to the nurse, no matter how slight the injury.
  • If a student must leave for reasons of health or injury, she should report to the nurse. The nurse will call for parental permission. A student should not use her cell phone or email to contact a parent.
  • The nurse will inform the faculty of the time the student left school.

Medications

  • All medication required by your daughter during the school day must be sent in the original labeled container, and administered by the school nurse, except in the case of emergency inhalers, Epipens, or diabetic supplies, and when it is checked off on the student medication form and signed by the physician.
  • The school stocked medications listed on the health form, will be made available to your daughter as needed if both the parent and physician has signed and dated.
  • Unused medications are to be picked up by a parent at the end of the school year and will be discarded 1 week from the last day of school.
  • For field trips, the parent needs to send in to the field trip faculty member, the home supply of any meds needed for that trip, (emergency or regular, prescription or non-prescription), as indicated on the field trip permission form.  First-time doses of any medications are to be taken at home.
  • For any changes in medications, taken at home or at school in the nurse’s office, the parent needs to email the school nurse to edit her record.

Illness / Injury / Restrictions

  • Parents may meet with the school nurse at the beginning of the year or during the year, to discuss any medical concerns for their daughter. They may also email the school nurse instead.
  • Students should stay home if they are not feeling well.
  • Students with a fever of more than 100 degrees, are to remain home until they are fever free for 24 hours, without the use of fever-reducing medicines. If a student is sent home from school with a fever, vomiting or diarrhea they must not return for 24 hours from the time of leaving school.
  • If a student sustains an illness or injury and requires accommodations, activity restrictions, uniform or shoe allowances, she must see the nurse upon return to school with the physician note indicating the diagnosis, duration of restriction and accommodation, and level of activity.
  • In the case of head injuries, she should also report to the Licensed Athletic Trainer at NDP, to cooperate with the “Return to Play” Plan and get instruction on how to begin and continue with the online concussion follow up testing for the XLNTBrain Sports concussion test.
  • The nurse will notify her teachers and advisors of the indicated restrictions and accommodations.

If you wish to print this information, download the document here: Injury & Illness Policy for all students