Student Health Services

Alexander Hamilton School: Kimberly Castelli, RN, MSN, CSN
Email: [email protected]
Nurse’s Office: 201-445-7700, ext. 8803


Health Office Mission Statement and Objectives

HEALTH SERVICES PROGRAM MISSION STATEMENT:  "You cannot educate a child who is not healthy, and you cannot keep a child healthy who is not educated."  This statement by the former US Surgeon General Jocelyn Elders, MD, clearly illustrates the very essence of the school nurse's mission.  Wellness does not just matter - it is critical.  It is critical not just for the student, but for teachers and staff as well.  School health awareness emphasizes the interaction of health and wellness with education and learning.  Our goal is to enable academic, social, physical, and emotional success by stressing prevention of disease and promotion of health and safety through individual counseling, education, and service.

New Student Required Health Documents

As per N.J.A.C 6A:16-2.2, students beginning school for the first time in NJ are required to submit an immunization record and physical exam completed and signed by a licensed healthcare provider.

Immunization Requirements (N.J.A.C. 8:57-4.1-4.24)

Physical Exam Required

A current physical must be handed in with your child’s registration. (completed within the last 365 days from a MD, APN or NP , signed and dated) 
You will have a 30 day provisional grace period, if not received before the start of school.   

Glen Rock School District Registration Information and Documents

It is recommended that students have annual physical exams; however, annual physical exams are not required after the initial entrance physical in elementary school.  Annual physical exam and immunization record documents are appreciated but not required.  
NJ State Health Screening Mandate
Students are screened for height, weight, blood pressure, vision, and hearing, as per the NJ State Board of Education guidelines.

Height/Weight: K-5
Blood pressure: K-5
Hearing: K, 1, 2, 3 
Vision: K, 2, 4
Scoliosis: 5  Permission slips will be sent home to either have done in school or with a private health care provider ( Results need to be forwarded to the health office).
 (Parents can opt for their own private licensed health care provider to perform the screening with a written notice and then submit medical documentation after the screening.)

**If any medical abnormalities are detected during screenings, parents will be notified.

Medical Plans & Medication Forms

Medical Plans

If your child has asthma, allergies, diabetes, or another medical condition that requires medical attention or intervention while in school, a medical action plan should be completed.  
Forms should be completed and signed by a licensed medical health care provider.  
Parents/guardians also should sign the forms and complete all parent/guardian sections (front and back).


If your child needs to take medication in school, a medication form needs to be completed by a licensed healthcare provider, signed, and stamped.  This form must also be signed by the parent/guardian.  
All medication should be submitted in its original container with the medication label on it.

Orthopedic Injuries

Medical note is required for use of the following during school hours:

Any orthopedic device

The following information must be included in the medical note for orthopedic injuries/devices:

Student may safely return with this device to school.
Student has been instructed in the proper use of the device.
Student is able to safely manage stairs with this device.
Approximate length of time the device will be required.
Date(s) of restriction from physical education/sports, including return to play date.


Forms and Resources

Allergy Action Plan.pdf
Allergy Action Plan

Asthma Tx Plan.pdf
Asthma Tx Plan

Medication Form

Universal Physical Form.pdf
Universal Physical Form

Vaccine Form.pdf
Vaccine Form

Influenza Information for Parents

Coxsackie virus in New Jersey.pdf
Coxsackie Virus Information

Designee Form0001.pdf
Emergency allergy designee form

Health History Form - Elementary Schools Only

Immunization Form - Elementary Schools Only

Medication authorization[1]byrd.doc
Medication Authorization Byrd School

Medication authorization[1]central.doc
Medication Authorization for Central School

Meningococcal_Disease_Rutgers_Fact_Sheet_05 03 2016 106426.pdf
Rutgers University Meningococcal Disease Information

Physical Examination Form - Elementary Schools Only

Public Health Advisory 2015 Pertussis Case Investigations Monmouth County.txt


Allergy Asthma Network
Asthma Information
Celiac Central
Choose My Plate
Food Allergy Information
NJ Parent Link

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