Forms & Screenings
Forms & Screenings
The following state-mandated screenings are conducted each year by the school nurses:
VISION: Grades 1 through 5, grade 7 and grade 10
HEARING: Grades 1 through 3, grade 7 and grade 10
POSTURAL (SCOLIOSIS): Grades 5 through 9
GROWTH (BMI): Grades 1, 4, 7 and 10
SCREENING, BRIEF INTERVENTION, AND REFERRAL TO TREATMENT (SBIRT): Grades 7 and 9
DPH and DESE have selected SBIRT utilizing the CRAFFT +N screening questionnaire as the approved approach to conduct verbal substance use screening in schools. SBIRT focuses on screening for prevention, risk assessment, brief counseling, and, when needed, referral for further treatment. It helps promote healthy behaviors and change unhealthy behaviors related to substance abuse.
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.pdfAllergy History Questionnaire
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.pdfAsthma Action Plan
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.pdfDiabetes Medical Management Plan
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.pdfEmergency Allergy Action Plan
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.pdfMassachusetts Certificate of Immunization
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.pdfMassachusetts Physical Exam Form
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.pdfMedication Permission Form
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.pdfRelease/Exchange of Information Form
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.pdfSeizure Action Plan
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.pdfSeizure Questionnaire
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.pdfHead Injury Recovery Plan and Accommodations