Ursulineacademy.net

Dear Parent/Guardian,
As the school year winds down and we look forward to a restful summer break, please attend to the following
important health information to ensure a smooth start for your daughter’s return to school in September.
1. Physical exam - Required for all students new to Ursuline Academy and all students entering grade 10.
Required for eligibility to participate in all sport, including tryouts in August.
MIAA rules dictate that the physical exam must be performed within the
previous 13 months for participation in any sport. No exceptions can be made.
Due in the Health Office by August 15, 2011*
* Late forms may result in a delay of participation, including tryouts.  Health forms, including copies of physical exams, must be sent to the School Nurse/Health Office as coaches may not accept health forms. 2. Immunizations - Required for all new students
 Proof of immunizations required by the Massachusetts Department of Public Health
must be submitted by August 15, 2011.
 Incoming grade 7 students only:
New Mass DPH regulations require the following additional immunizations for the 2011- 2012 school year: 2 doses of varicella vaccine
1 dose of Tdap
 No student will be admitted to school in September without documentation of required
immunizations on file in the Health Office.

3. Medications - Require a signed doctor’s order and signed parental consent. A verbal consent via phone
 A signed doctor’s order form and a signed parent consent form must be on file in the
Health Office for a student to receive any medication during the school day, including over-
the-counter medications such as Tylenol or ibuprofen (Advil, Motrin). (105 CMR 210.000)
 A student may not carry medication or self-medicate without a signed doctor’s order and
a signed parent consent form on file and permission from the School Nurse. This includes
over-the-counter medications such as Tylenol and ibuprofen (Advil, Motrin). (105 CMR 210.006) 4. Individual Health Care Plan –
Please contact the School Nurse by August 15 if your child has an existing medical condition that requires medication, monitoring or potential emergency intervention during the school day. This includes, but is not limited to, a severe/life threatening allergy; asthma; diabetes, seizures, and migraine headaches.  If your daughter has been diagnosed with a severe allergy for which she has been prescribed an Epi-pen, please contact the School Nurse before the start of the school year to discuss
your daughter’s Allergy Action Plan and to arrange delivery/storage of backup medication
(EpiPen, Benadryl) in the Health Office.
 for detailed information on admission health requirements and health policies and Be sure to check the Health Office Edline link periodically throughout the school year for important school health updates as well as information and topics relevant to your daughter’s health and well-being. To ensure confidentiality, address all health records to the attention of the School Nurse at: Ursuline Academy 85 Lowder Street Dedham, MA 02026 You may contact me at school at (781) 326-6161 X105 with any questions, comments or to request paper copies of the health information and forms available online. Thank you for your prompt attention and cooperation.

Source: http://www.ursulineacademy.net/uploaded/1_About-Ursuline/documents/Health_Office_Forms/September_Health_Requirements.pdf