Health Forms & Resources - Barrie School, The

Health Forms and Resources

Welcome from the School Nurse

Kirstie Abernathy MS, RN, CPN

Upper Campus Health Office
Neubert Cottage (12 months - Grade 3)

Lower Campus Health Office
Upper Elementary Building (Grades 4-12)

Phone: 301-576-2814

Email: kabernathy@barrie.org or nurse@barrie.org

Email to Submit Forms: healthforms@barrie.org

Visit the Health and Wellness Blog!

The School and Camp Nurse is responsible for monitoring the health and wellness of Barrie students and campers, and is available to assist staff with medical emergencies. The Nurse provides first aid, maintains student health records, administers medications on campus, monitors allergies and illnesses, conducts health screenings, and consults and promotes health and wellness with students and faculty.

The Health Office does not function as a primary care facility or urgent care. By law, school nurses are not able to make medical diagnoses or prescribe treatments but may assess, and serve as a resource for referrals to off-campus professionals as needed. The School Nurse works closely with Barrie's Student Support Services Team to best meet student health needs.

When accidents, injuries or illnesses occur during school hours, basic first aid and/or emergency care will be given according to the Maryland Board of Nursing standards and practices. Please ensure that your emergency contact information is up to date so that the nurse can contact you in the event of student illness requiring pick up or emergency services.

Health Policies

When to Keep Your Child at Home | Barrie School Food Allergy Policy | Barrie School Head Lice Policy

Health Forms - Due June 1, 2021

To access Barrie Camp Medical Forms, please log into your CampInTouch account.

Health Forms - Due June 1, 2021

Completed forms that are turned in for 2021 Barrie Camp and/or summer programs will be used for the 2021-22 school year. A second set of forms is not required. However, additional forms may be required in order to comply with the health form requirements as specified by student’s grade level.

All school health forms MUST be completed and on file by June 1, 2021. Incomplete health forms or medication forms could potentially delay the student’s start date. In addition to the admissions forms required for enrollment, the forms below are REQUIRED in order for students to be able to start school.

Required Forms for New and Returning Barrie School Students 2021-22

The following forms are required by the State of Maryland. Students will NOT be allowed to start school or participate in any Barrie sponsored activities including off campus trips and athletics without completed health forms on file.

Instructions
Medical forms should be submitted electronically via email to the health forms inbox, healthforms@barrie.org or faxed directly to the health office at 301-576-2805. Please retain all hard copies for your records.

Deadlines

Barrie School
- All returning and newly enrolled students: Health Forms are due no later than June 1, 2021

Please contact School Nurse Kirstie Abernathy at 301-576-2814 if you have questions regarding the forms and what is required.

Lower School (Montessori) Toddler - Grade 5

All Toddlers (T1, T2)

Emergency Form	Health Assessment Part I	Health Assessment Part II	Immunization Certificate	Blood Lead Testing Certificate	Medication Forms
OCC Emergency Form	OCC Health Assessment I	OCC Health Assessment II	Maryland Immunization Certificate	Included in OCC Health Assessment II	Medication Administration Form OCC Medication Forms - Do not use Barrie medication form for students 12 months - Kindergarten (P5)

All New and Returning Primary Students (P3, P4, P5)

Emergency Form	Health Assessment Part I	Health Assessment Part II	Immunization Certificate	Blood Lead Testing Certificate	Medication Forms
OCC Emergency Form	OCC Health Assessment I	OCC Health Assessment II	Maryland Immunization Certificate	Included in OCC Health Assessment II	Medication Administration Form OCC Medication Forms - Do not use Barrie medication form for students 12 months - Kindergarten (P5)

Elementary (Grades 1-5)

All New Students (Grades 1-5)

Emergency Form	Health Assessment Part I	Health Assessment Part II	Immunization Certificate	Blood Lead Testing Certificate	Medication Forms
Emergency Contact Form	Health Assessment Part I	Health Assessment Part II (Physical Exam completed by Physician)	Maryland Immunization Certificate	Students 12 months - Grade 1 Only	If applicable. See Medication, Asthma, and Anaphylaxis Forms section below.

Returning Students (Grades 1-2)

Returning Students (Grade 3)

Returning Students (Grades 4-5)

Middle & Upper School (Prep) Grades 6-12

New Students (Grades 6-12)

Emergency Form	Health Assessment Part I	Health Assessment Part II	Immunization Certificate	Blood Lead Testing Certificate	Medication Forms	Sports Physicals
Emergency Contact Form	Health Assessment Part I	Health Assessment Part II (Physical Exam completed by Physician)	Maryland Immunization Certificate	Students 12 months - Grade 1 Only	If applicable. See Medication, Asthma, and Anaphylaxis Forms section below.	Grades 6-12 Sports Evaluation Form Only if participating in Athletics

Returning Students (Grade 6)

Emergency Form	Health Assessment Part I	Health Assessment Part II	Medication Forms	Sports Physicals: REQUIRED every 13 months for students participating in Athletics
Emergency Contact Form	Health Assessment Part I	Health Assessment Part II (Physical Exam completed by Physician)	Updated forms if applicable. See Medication, Asthma, and Anaphylaxis Forms section below.	Sports Evaluation Form

Returning Students (Grade 7)

Emergency Form	Health Assessment Part I	Immunization Certificate	Medication Forms	Sports Physicals: REQUIRED every 13 months for students participating in Athletics
Emergency Contact Form	Health Assessment Part I	Maryland Immunization Certificate	Updated forms if applicable. See Medication, Asthma, and Anaphylaxis Forms section below.	Sports Evaluation Form

Returning Students (Grade 8)

Returning Students (Grade 9)

Emergency Form	Health Assessment Part I	Health Assessment Part II	Medication Forms	Sports Physicals: REQUIRED every 13 months for students participating in Athletics
Emergency Contact Form	Health Assessment Part I	Health Assessment Part II	Updated forms if applicable. See Medication, Asthma, and Anaphylaxis Forms section below.	Sports Evaluation Form

Returning Students (Grades 10-12)

Medication, Asthma, and Anaphylaxis Forms

Medication, Asthma, and Anaphylaxis Forms

Medication Forms

Authorization to Administer Medication Form: Use this form for students requiring prescription medication or OTC medications (including topical creams, cough drops, and cough syrups, NOT Benadryl, Tylenol and Ibuprofen). This form can be completed once for the entire school year by a prescribing provider (physician, nurse practitioner, physician’s assistant, dentist, etc.). A new form is required for each medication.

Stock Over-The-Counter (OTC) Medications: Barrie School Over-The-Counter Medication Authorization Form - To be completed by a prescribing provider and the parents for the administration of Benadryl, Tylenol, or Ibuprofen as needed while at school. This form must include specific dosages and requires a physician and parent signature.

Medication forms must be completed for students who have been authorized to self-carry and self administer emergency medications (inhaler, epipens and diabetes medications). On the first day of school, the student will be required to check in with the school nurse to review medications and forms as well as verify expiration dates for the medications that they will be self-carrying while at school.

Overnight School Sponsored Activities Form - For students in grades 9-12 who require medications and are able to to self-administer on overnight trips, a Barrie School Self-Administration of Medication Authorization Form may be completed by a prescribing provider and the parents. Please note this is for OFF campus activities only. Students are not permitted to self-medicate at school except for Epi-Pens and emergency inhalers. The form is valid for the entire school year.

Asthma and Anaphylaxis

Asthma: Asthma Action Plan - An Asthma Action Plan is available for students diagnosed with asthma, to be completed by a prescribing provider and parents.

Anaphylaxis: Emergency Care of the Student with a Diagnosis of Anaphylaxis Form - Required for students who have a severe life-threatening allergy and require an Epi-Pen. To be completed by a prescribing provider and the parents. Parents are responsible for supplying the school two (2) Epi-pens of appropriate dosage and two (2) photos of the student.