May 2011
Dear Parents of Students New to Fairfield Prep:
The health services to students at Fairfield Prep include the immediate care of the sick and injured, vision tests, scoliosis screening, an immunization program, dental program, health counseling, the maintenance of all medical records, organizing special health programs and assistance for students with special health needs. When a student is seriously ill or injured a parent or specified friend or relative will always be notified. Prep requires parents to furnish transportation home unless an ambulance has been called.
Each student must submit a physical exam done within a year of entry to Prep. This exam form must include proper immunization dates and be received by the School Nurse no later than August 12, 2011. Please have your physician complete the state Health Assessment Record Form enclosed. All physical exams done within a year are valid; however, your son would need to stop competing in sports on the date the physical expires. This is why we suggest that the exam be done in the summer guaranteeing the entire academic year is covered. In compliance with Connecticut State law, a completed medical exam must be on file before a student may enter Fairfield Prep. Please bring the summary check list to the physician’s office at the time of the physical (on other side of this letter).
Please forward the enclosed release form to your son’s present school. This form requests the release of his complete original health records, not copies, to the Fairfield Prep Health Office. Problems can be avoided in the fall if you contact your son’s school nurse now and request that she forward the records to Prep at the end of this school year. All medical records from your son’s school must be received by us no later than the first day of school.
Our policy on medications at school is as follows: No medication, whether given by the nurse or self-administered by the student, is allowed without a physician signed authorization form, which is enclosed and also posted on the web site. This includes prescription and other over the counter medications ( such as Tylenol, Advil, EpiPens and the use of inhalers).
Your son’s record is confidential and information is released only with your permission. Please provide me with any information regarding your son’s health as I act as a liaison person between Prep and parents. I am happy to assist you with any questions you may have during the year. I can be reached at 254-4200, ext. 2628.
I look forward to meeting your son in the fall.
Sincerely,
Mary Ellen Lehmann, R. N. (over)
WE SUGGEST YOU BRING THIS CHECKLIST TO THE PHYSICIAN’S OFFICE AT THE TIME OF THE PHYSICAL EXAM.
SUMMARY CHECKLIST
1. Complete the front parent page of the (blue )state of Connecticut Health Assessment Record form.
2. Have your physician complete part 2 “Medical Evaluation” and the Immunization Record page , including month, day and year of the following tests and immunizations:
a. Diptheria, Tetanus, Pertussis (i.e. - DTP/DTAP/Td/Tdap) – minimum of three doses
(last dose given on or after 4th birthday).
b. Polio – minimum of three doses (the last dose given on or after the 4th birthday).
c. Measles, Mumps, and Rubella-(MMR) – two doses (the first must have been given on or after the 1st birthday)
d.. Varicella (VZV) (Chicken Pox) – one dose given on or after the first birthday and before the thirteenth birthday. OR two doses given at least four weeks apart, if the first dose was given on or after the thirteenth birthday.
e. Hepatitis B (HBV) – three doses-Two doses( given at least four weeks apart) followed by a third dose at least eight weeks after the second dose .
The 3rd dose shall be given no earlier than twenty-four weeks of age.
f. TEST FOR TB-ANY STUDENT ENTERING FROM ANOTHER COUNTRY MAY NEED TO BE TESTED.
3. If applicable, have your physician complete the accompanying medication order form (“Authorization for Administration of Medication”). You must also complete the section for parental permission(authorization).
4. Contact your son’s present school nurse, and be certain that she has been notified, by her school, that a permission form to release school records is on file. Please check in the beginning of September to confirm that his records were sent to Fairfield Prep.
5. Send all documents to: Mrs. Mary Ellen Lehmann, RN, Fairfield Prep, 1073 North Benson Road, Fairfield, CT 06824 (envelope enclosed) by August 12, 2011.