Medical Information

For information on keeping children home because of illness please see
Absences and Lateness or the BACS Handbook section 9: Health.

The state of Pennsylvania requires that medical and dental forms be filled out by the examining doctor or dentist at certain grade levels. They also require the submission of vaccine records for all Kindergarten and other new students to BACS, and a vaccine update for those entering 7th grade. If your child is on a delayed vaccine schedule, please provide a yearly vaccine update.

The Standing Orders Form, completed as part of the summer database information update, allows parents to choose from a list of commonly used over-the-counter medications to be given on as needed basis during school hours. These include: acetaminophen, ibuprofen, Benadryl, Epi-pen, Tums, Ludens throat drops, Hydrocortisone cream, insect sting swabs, antibiotic ointment and Silvadene cream.  

All other medication, over-the-counter and prescription, require submission of a Medication Administration Consent and Licensed Prescriber Order to be given at school.  Please submit an Asthma Action Plan with paperwork for inhalers and an Allergy Emergency Plan with paperwork for Epi-pens.

Please feel free to contact me with any questions.

Kathy McQueen, BSN, RN, CSN
Kathy.McQueen@bacs.org

 

Medical Forms Overview

Please return ALL forms by August 1st. If you are unable to get a doctor’s appointment prior to this date, you must send an email providing the date of the scheduled appointment and submit a copy of your child’s most recent physical and immunization records. It is important that I receive these forms in a timely manner so that they can be processed and arrangements can be made to meet your child(ren)’s needs.

Your child(ren) will not be permitted to start school if their forms and immunization records have not been received.

The specific forms required vary by grade. You can view, and download, the appropriate forms for your child in the section BACS Medical Forms by Grade below.

BACS Medical Forms by Grade

Pre-School

Kindergarten and All New Students

Private or School Physical Exam and Private Dentist Report
The State of Pennsylvania requires the following immunizations for attendance at all grade levels: DTaP, Polio, MMR, Hepatitis B and Varicella OR a statement of exemption from immunization.( See the “Required Immunizations for the State of Pennsylvania” tab below.)

It is a Pennsylvania state law that children entering Kindergarten (and all new students) must have a physical and dental examination (filled out and signed by doctor/dentist).

1st grade

No additional forms required for returning students. 

2nd grade

No additional forms required for returning students. 

3rd grade

Private Dentist Report
It is a Pennsylvania state law that children entering 3rd grade have a dental examination (filled out and signed by dentist).

4th grade

No additional forms required for returning students.

5th grade

Sports Physical Examination
It is a BACS requirement that all students who wish to participate in the After School Sports have a sports physical examination (filled out and signed by doctor).

6th grade

Private or School Physical Exam and Sports Physical Exam
It is a Pennsylvania state law that children entering 6th grade have a physical examination.
It is a BACS requirement that all children who wish to participate in the After School Sports have a sports physical examination. (filled out and signed by the doctor).

7th grade

Private Dentist Report and Sports Physical Examination
The State of Pennsylvania requires the following immunizations for entry into 7th grade: Tdap and Menactra OR an updated statement of exemption from immunization. (See the “Required Immunizations for the State of Pennsylvania” tab below.)

It is a Pennsylvania state law that children entering 7th grade have a dental examination (filled out and signed by the dentist).
It is a BACS requirement that all students who wish to participate in the After School Sports have a sports physical examination (filled out and signed by the doctor).

8th grade

Sports Physical Examination
It is a BACS requirement that all students who wish to participate in the After School Sports have a sports physical examination (filled out and signed by the doctor).

Information About Medical Forms

Private or School Physical Exam

The Private Physical Examination of School Age Student is a Pennsylvania state requirement for all Kindergarten, 6th grade students and new students. The first page is a health history that is filled out by the parents. The physical exam and vaccine records should be filled out and signed by the doctor.

Sports Physical Evaluation

The Sports Physical Evaluation is required for all students, 5th – 8th grade, who want to participate in the Extra PE program. This form must be filled out and signed by your child’s doctor and is good for the entire school year.

Private Dentist Report

The Private Dentist Report is a Pennsylvania state requirement for all Kindergarten, 3rd grade and 7th grade (and all new students in other grade levels).

Required Immunizations for the State of Pennsylvania

Children in all grades (K-8) need the following immunizations for attendance:

  • 4 doses of tetanus, diphtheria, and acellular pertussis
  • 4 doses of polio
  • 2 doses of measles, mumps, rubella
  • 3 doses of hepatitis B
  • 2 doses of varicella (chicken pox) or evidence of immunity

Additional immunization requirements for entrance into 7th grade:

  • 1 dose of meningococcal conjugate vaccine (MCV)
  • 1 dose of tetanus, diphtheria, acellular pertussis (Tdap booster)

Children who are not fully immunized according to the requirements set forth by the state of Pennsylvania must have a signed exemption statement citing the reason why vaccines were not given. If your child is exempt from immunizations he or she may be removed from school during an outbreak.

Statement of Exemption to Immunization

The Statement of Exemption to Immunization card is available at the school office for new parents who might want to choose this option. These cards are available to other parents upon request.

Exemptions to the school laws for immunization include:

  • medical reasons
  • religious reasons
  • philosophical or strong moral or ethical conviction

Medication Administration Policy and Consent Form

The The Medication Administration Policy and Consent Form outlines the protocol for administration of medication at BACS during the school day. This includes all over-the-counter and prescription medications that are not part of the “standing orders” list (i.e. Tylenol, ibuprofen etc.). The Medication Administration Consent and Licensed Prescriber Order should be submitted along with the prescribed medication (i.e. Excedrin migraine, stimulants for ADHD, medication for seasonal allergies etc.). This order must be updated yearly.

Allergy Emergency Plan

An Allergy Emergency Planshould be in place for all students with a potentially life threatening allergy (i.e. bee sting, food allergy etc.). The allergy emergency plan should be completed by the child’s physician and submitted to the school along with the prescribed medication (i.e. Epi-pen). The allergy emergency plan must be updated yearly.

Asthma Action Plan

An Asthma Action Plan should be in place for all students who have an asthma inhaler/nebulizer medication at school. The asthma action plan should be completed by the child’s physician and submitted to the school along with the prescribed medication (i.e. inhaler, nebulizer treatments). The asthma action plan must be updated yearly.

Other Medical Information

Head Lice

Absences Due to Illness

Top