PVPA is now a NUT-FREE campus. Please adjust home-brought meals accordingly. Thank you! 

 

Back-to-School Medical Forms

Medical symbol superimposed over the PVPA logo

Dear Caregivers,

Your student's safety, health and well-being are paramount to all of us at PVPA.

With that in mind we need your help to make sure that we have all of the most up-to-date MEDICAL AND MEDICATION INFORMATION regarding your student.

ALL STUDENTS MUST HAVE AN UP TO DATE  Emergency/Health Form COMPLETED EVERY YEAR. Please complete this form before August 30, 2021. You can deliver it to me at school, scan and email it to me (mcolwell@pvpa.org), or fax it to me @ 413.552.1573

Students with any of the following  must complete the appropriate medical forms and return them to me by August 30, 2021:

  • Students who take Prescription Medication at school
  • Have a Life-Threatening Allergy, Asthma, Diabetes, Seizure Disorder, or other Medical Condition

 

Students Taking Prescription Medication at School

For all medical conditions that require prescribed medication and for all students who take prescribed medication during the school day we must have a current Medication Authorization form filled out by you and your child's physician. It will be filed in your student's health record at school. 

All prescription medication to be taken during school hours must be delivered directly to the School Nurse by the parent in their student’s original prescription bottle.


Life Threatening Allergies

If your student has a life threatening allergy, a current Anaphylaxis Emergency Action Plan form as well as a Medication Authorization form must be filled out and signed by you and your child's physician. It will be filed in your student's health record at school.

Their epinephrine auto-injector and/or Inhaler must be brought to school by you in the prescription box that you received from your pharmacy.

Your student must carry their epinephrine auto-injector with them during the school day and we must have an additional epinephrine auto-injector for them to be stored in the nurse's office at school.  


Asthma

If your student has asthma, a current Asthma Action Plan form must be filled out by your child's physician as well as a Medication Authorization form filled out and signed by you and your child's physician. It will be filed in your student's health record at school. 

Their inhaler must be brought to school by you in the prescription box that you received from your pharmacy.

Your student must carry their inhaler with them during the school day and we must have an additional inhaler for them to be stored in the nurse's office at school.  


Diabetes, Seizure disorder or other Medical Condition

For students who are diabetic, have a seizure disorder or other medical condition please contact me directly and we will develop, together, a Medical Action Plan approved by your child’s physician for their health and safety.

Please complete all necessary forms before August 30, 2021. You can deliver it to me at school, scan and email it to me (mcolwell@pvpa.org), or fax it to me @ 413.552.1573

 

THANK YOU and thank you!

My very best to you,
Mary