Nurse Consent Form

Please fill out one form for each child registered at Saint Michael School.

Saint Michael School Parents, August 26, 2020

Saint Michael School is making the appropriate changes during COVID 19. Our school will have hand sanitizers in every classroom for student and teacher access. Students using hand sanitizer will be supervised by staff. Parents are asked to give permission to
allow each one of your children access to hand sanitizer. Protecting our Saint Michael community during COVID 19 is our number one priority.

The Department of Public Health has added a new influenza vaccine required for all school aged children. This requirement was put in place to reduce influenza- related morbidity and to reduce the overall impact of respiratory illness in a population still facing COVID 19 pandemic. Children will be expected to have received an influenza vaccine by December 31 st unless they have a medical or religious exemption. Written proof of immunizations is required to be one file in the nurse’s office.

The staff at Saint Michael School appreciates the parents understanding during the COVID pandemic. If you have any questions please call the school nurse.

Kelsey Valente L.P.N.

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(Parent/Guardian) *

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Last

Child Name *

First

Last

Use of Hand Sanitizer *

Permission No Permission

Grade/Teacher *

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Nurse Consent Form

​Nurse Consent Form

Nurse Consent Form