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Enrollment Health Forms
If you are registering a new student to MCPS, in addition to updated immunization records, you will need the following forms to be completed and returned to school:
- Health Inventory Form known as the Student Record Card 6 (https://ww2.montgomeryschoolsmd.org/departments/forms/pdf/sr-6.pdf)
- Please complete part I and have the Pediatrician complete part II
- Dental Health Form (https://ww2.montgomeryschoolsmd.org/departments/forms/pdf/525-17.pdf)
- Please complete section I and have the dentist complete section II
- Blood Lead Testing Certificate (https://ww2.montgomeryschoolsmd.org/departments/forms/pdf/dhmh%204620.pdf)
- Follow instructions on the form. If the student has resided in a high-risk area, please have him/her tested by the Pediatrician and have the Pediatrician complete Section C.
*If your child is uninsured, please contact the School Nurse at 240-740-4152
Incoming 6th graders
Montgomery County Public Schools and the Montgomery County Department of Health and Human Services recommend that all children entering Grade 6 be examined by a health care provider and a dentist.
Please submit the following forms to the health room upon entering Grade 6:
- Health Inventory Form known as the Student Record Card 6 (https://ww2.montgomeryschoolsmd.org/departments/forms/pdf/sr-6.pdf)
- Please complete part I and have the Pediatrician complete part II
- Dental Health Form (https://ww2.montgomeryschoolsmd.org/departments/forms/pdf/525-17.pdf)
- Please complete section I and have the dentist complete section II
Incoming 7th graders
The Maryland school immunization regulations (COMAR 10.06.04) require children enrolled in school to show proof of having completed required immunizations.
All Grade 7 students must have both a Tetanus, diphtheria, acellular pertussis (Tdap) and meningococcal (MCV) vaccine. Parents/Guardians are urged to provide to the health room the documentation of the Tdap and MCV immunizations as soon as possible this current school year, or before the first day of school next year.
Medication Administration during School Hours
If your child needs to take medications during school hours, please complete section I of the form and have the doctor complete and sign the form. Ensure that you are bringing a new medication bottle to the school and that the ordering doctor is the same doctor listed on the medication.
- Authorization to Administer Prescribed Medication Form (https://ww2.montgomeryschoolsmd.org/departments/forms/pdf/525-13.pdf)
- Please use this form for oral medications and inhalers.
Emergency Medication Administration during School Hours
If your child suffers from severe allergies and requires the use of Epinephrine, please complete section I and have the Pediatrician complete section II.
- Authorization to Administer Emergency Prescribed Medication for Anaphylaxis (https://ww2.montgomeryschoolsmd.org/departments/forms/pdf/525-14.pdf)
Spanish
Documentos necesarios para inscripción
Todo estudiante nuevo, aparte de record de vacunación, necesita los siguientes documentos:
- Formulario de Inventario de Salud, conocido como la Tarjeta de Expediente del Estudiante SR-6 (https://ww2.montgomeryschoolsmd.org/departments/forms/pdf/sr-6_spanish.pdf)
- Por favor complete la parte I y el medico completa la parte II
- Formulario de Salud Dental (https://ww2.montgomeryschoolsmd.org/departments/forms/pdf/525-17_spanish.pdf)
- Por favor complete
- Certificado de Prueba de Plomo del Estado de Maryland (https://ww2.montgomeryschoolsmd.org/departments/forms/pdf/dhmh%204620_spanish.pdf)
*Si su hijo/a no tiene seguro médico, por favor llame a la Enfermera del Colegio al 240-740-4152.
Estudiantes entrando a 6 to grado
Las Escuelas Públicas del Condado de Montgomery y el Departamento de Salud y Servicios Humanos recomiendan que todos los niños que comienzan el sexto grado sean examinados por el médico y el dentista.
- Formulario de Inventario de Salud, conocido como la Tarjeta de Expediente del Estudiante SR-6 (https://ww2.montgomeryschoolsmd.org/departments/forms/pdf/sr-6_spanish.pdf)
- Formulario de Salud Dental (https://ww2.montgomeryschoolsmd.org/departments/forms/pdf/525-17_spanish.pdf)
Estudiantes entrando a 7 tmo grado
Los reglamentos de vacunación de las escuelas de Maryland (COMAR 10.06.04) requieren que los estudiantes que están inscritos en las escuelas muestren prueba de que ya han completado todas las vacunas requeridas.
Todos los estudiantes del Séptimo grado deben tener la vacuna del Tétano, difteria y la tos ferina acelular (Tdap), y la vacuna meningocócica (MCV). Estamos pidiendo que los padres/apoderados del estudiante muestren prueba de estas vacunas de su hijo(a) a la sala de la enfermera escolar lo más pronto posible este año escolar, o antes del primer día de escuela del próximo año escolar.
Administración de Medicamentos durante horas escolares
Si su hijo/a necesita tomar un medicamento en horarios de colegio, por favor complete parte I del formulario y que su médico complete parte II. Asegúrese de traer un nuevo frasco de medicamento al colegio y que el doctor que receto el medicamento es el mismo doctor que completo el formulario.
- Autorización Para Suministro de Medicamento Recetado (https://ww2.montgomeryschoolsmd.org/departments/forms/pdf/525-13_spanish.pdf)
Administración de Medicamentos de Emergencia
Si su hijo/a sufre de alergias severas y usa epinefrina, por favor complete parte I del formulario y que su médico complete parte II. Por favor asegúrese de traer epinefrina que no está expirada y que el doctor que receto la epinefrina sea el mismo que completo el formulario.
- Atención de Emergencia para Estudiantes con Diagnostico de Anafilaxia (https://ww2.montgomeryschoolsmd.org/departments/forms/pdf/525-14_spanish.pdf)
