Mrs. Mary Kay Rogowski, RN, FNP, MSN
Mrs. Julie Duffy, RN, BSN
Mrs. Maria O’Connell, Nurse Assistant
Commonwealth of VA School Entrance Form
Medication Authorization Form
Asthma/ Inhaler Action Plan
Inhaler Autorization Form
Epinephrine Authorization Form
Severe Allergy/Anaphylaxis Action Plan and Treatment Authorization
Antihistamine Authorization Form
Additional Severe Allergy Information Form
Safe Snack Guide
For those students who are new at St. Timothy School, please ensure that all ” Commonwealth of Virginia School Entrance Health Forms ” are in the office no later than August 1st. For those students who have transitioned from preschool to kindergarten, please have the physician’s office complete the form. Remember to copy the original health assessment for your records before submitting the original to the school. Emergency care information is due by the first day of school for each child in a family.
According to the Virginia Department of Health, “No student shall be admitted by a school unless at the time of admission the student or his parent submits documentary proof of immunization to the admitting official of the school.” Vaccines must be administered in accordance with the Centers for Disease Control spacing and age requirements.
The requirements mandate that the following four immunizations must be in place for students:
- A second dose of Varicella Vaccine is required before entering kindergarten.
- A second dose of Mumps Vaccine is required before entering kindergarten.
- Four (4) doses of Polio Vaccine are required, with one dose being administered on or after the fourth birthday, for all new students enrolling in your schools (Kindergarten – 12th grade).
- Four (4) doses of DTaP Vaccine are required, with one dose being administered on or after the fourth birthday, for all new students enrolling in your schools (Kindergarten – 12th grade).
If your child needs a medication, please ask the physician to space the dosages around school time (for home administration). If this is not possible, please print and complete the appropriate medication form. Remember that each medication has its own form. All medications must be in the original prescription container with the following information: student’s name, license prescriber’s name, medication name, medication dosage, administration frequency, and the prescription fill/expiration dates. Medications cannot be administered out of plastic bags or other non-original containers. NO MEDICATION (PRESCRIPTION OR NON-PRESCRIPTION) IS PERMITTED IN THE CLASSROOM AT ANY TIME INCLUDING ASPIRIN, TYLENOL, COUGH DROPS, ETC.. All over-the-counter medications must be brought to the office in their original container upon arrival to school. At the end of the school year, the parents/guardians must pick up the remaining medication. We are not able to release medications back to the student. Upon school closure, any remaining medication will be disposed of.
Student absences must be accounted for by a written note to the classroom teacher upon return to school stating the reason for the absence. We also ask that you notify the office if your child is absent for more than three days. Parents of Junior High students must call the office each day that a student will be absent. Following these simple procedures will decrease the classroom and parental interruptions. If your child contracts a communicable disease, i.e., chicken pox, please inform the clinic immediately.