• Dear SVMS Parents,

    Every child in PreK - 8th grade is required to have an annual physical examination done by their physician.  This exam certifies that the student is cleared to participate in sports at our school as well as physical education classes during the school year.  In addition to these forms, please provide a copy of your child’s most recent vaccination record so any updates on their vaccination record kept on file at school can be made.

    Please email me to find out what paperwork I have on file for your child.  The most recent physical exam paperwork I have for some students dates back more than 2 years ago.  Please note that your child will not be able to participate in any sports program at SVMS until the appropriate paperwork is submitted. If you wish your child to have any medications such as Acetaminophen/Tylenol or Motrin/Advil you will need to fill out the Mandatory Medication Form.  This form will need to be filled out if your child takes regular prescription medications as well.  This form requires both your signature as well as your child’s physician's signature.  I know there is a space on the Emergency Card that you filled out giving permission to give Tylenol, but that is no longer appropriate and cannot be used instead of this medication form. 

    Please keep in mind that if you’d like to have your child receive any medication you MUST provide me with whatever medication you wish to have stored at school (along with aforementioned form).  The medication MUST be labeled by you with the students name and prescription medications should be kept in the original box with the child’s name on it.  I will not be able to administer any medication to your child if you do not provide me with it. 

    If your child has Food Allergies, the FARE form will need to be filled out by your child’s physician and you will need to provide the required medications prescribed for your child including your child’s epi-pen.  If your child has asthma and requires an inhaler, then the Asthma Treatment Plan must be filled out by your child’s physician and you will need to provide me with their prescribed inhaler.  These forms are required by the state to be filled out annually and the epi-pens and inhalers need to be replaced annually as well.

    You will also find a link before the physical exam forms titled “Permission To Share Information.”  This form is required for each child.  This is essentially a HIPPA form that was created for schools.  You are giving permission to share any pertinent medical information amongst appropriate faculty/staff.  Be assured that any information regarding your child will NOT be shared with other students or any other families at school.  Again, it is so that faculty and staff can be made aware of any pertinent medical condition your child may have if they ever come into contact with them.  One example would be sharing information about a Food Allergy a certain child might have.  Another example would be sharing information if a student has diabetes.   This is so that faculty/staff members would be aware and could report any signs of a child in distress knowing what could possibly be the trigger in order that the child get immediate medical attention.

    Please feel free to contact me if you have any questions. 

    Thank you in advance for your prompt response to this matter.

    Best regards,
    Renee Reilly, RN
    973-377-1104 Ext 211

Preschool Physical Exam Forms (2020 - 2021)

Grades K - 5 Physical Exam Forms (2020 - 2021)

Grades 6 - 8 Physical Exam Forms (2020 - 2021)

Supplemental Physical Exam Forms (2020 - 2021)

Medication Forms (2020 - 2021)

Lice Treatment (2020 - 2021)

Summer Safety Forms (2020 - 2021)