187 Wyckoff Avenue
Ramsey, New Jersey 07446 
Phone: 201-327-1108
Fax: 201-236-1318

academyofstpaul@academyofstpaul.org
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Health
Authorization for Administration of Medications - Prescribed and Over-the-Counter (pdf)
Archdiocese of Newark CYO Leagues Forms (pdf)
Asthma Treatment Plan (pdf)
Consent for Administration of Epinephrine by Delegate (pdf)
Dental Examination Form (pdf)
Eye Examination Form (pdf)
Food Allergy Policy (pdf)
Food Allergy & Anaphylaxis Emergency Plan (pdf)
Health History Update Questionnaire (HHQ) (pdf)
Instructions For Completing Sports Physicals PPE & HHQ (pdf)
Personal and Family History Form (pdf)
PreParticipation Physical Evaluation (PPE) (pdf)
Sports Related Concussion Fact Sheet Sign-Off (pdf)
Sports Related Eye Injury Fact Sheet with Sign-Off (pdf)
Student Illness (pdf)
Sudden Cardiac Death Sheet Sign-Off (pdf)
Universal Child Health Record Grades PreK - 2 (pdf)
When to Return to School After Injury or Illness (pdf)

 

Health Office  
 
It is desirable that our students be in the best health possible to meet the demands of the academic and physical education/ sports programs at the Academy of St. Paul.   

All 2019-2020 health and medical forms related to your child’s/children’s health are available for you to access online (See: left margin). All students must submit a current physical examination report. To be considered current, the physical examination is to be conducted after January 1,  of the respective school year. If, due to insurance restrictions, your child’s appointment is delayed until after school begins in September 2019, please notify the Nurse directly at: (201) 327-1108.  The office is staffed by School Nurse, 8:30 AM to 2:30 PM, Monday through Friday. Please feel free to contact the nurse with any health concerns.  

Health Assessment and Medical Examination Requirements

Preschool 3 through Grade 2

Please print and take ALL of the required forms listed below to your physician. Forms must be completed and signed as noted by parent or guardian AND physician and returned to the school no later than August 1.  

1. Personal and Family History  

5. Allergy/Anaphylaxis Emergency Care Plan (if applicable)   

2. Physical Examination Report (eye and hearing examinations should be included). Universal  6. Consent for Administration of Epinepherine via Auto- Injector by a Delegate (if applicable)  
3. Immunization Record    7. Asthma Treatment Plan (if applicable)    
4. Authorization to Administer Medications   8. Complete Dental Examination recommended each year.

Please note: Allergic/Anaphylaxis Care Plan and Asthma Plan forms are only for children with treatment plans for allergic reactions or asthma. These must be updated annually by your physician.

Grades 3 through 8 

Please print and take ALL of the required forms listed below to your physician. Forms must be completed and signed as noted by parent or guardian AND physician and returned to the school no later than August 1.  

 1. Personal and Family History  

5. Allergy/Anaphylaxis Emergency Care Plan (if applicable)   

2. Physical Examination Report 

Grade 3: (eye and hearing exams should be included);

Grades 4-8: (eye examinations and hearing exams MUST be included)

6. Consent for Administration of Epinepherine via Auto- Injector by a Delegate (if applicable)  
3. Immunization Record    7. Asthma Treatment Plan (if applicable)    
4. Authorization to Administer Medications   8. Complete Dental Examination recommended each year.

Please note: Allergic/Anaphylaxis Care Plan and Asthma Plan forms are only for children with treatment plans for allergic reactions or asthma. These must be updated annually by your physician.

Athletics

Athletic Preparticipation Physical Examination (PPE) and Health History Questionnaire (HHQ)

**Please read instructions for completing the PPE or Health History Questionnaire (HHQ). (See: left margin) 

If your child will participate on an athletic team, please note a current Preparticipation Physical Evaluation (PPE) form must be on file in the nurse's office prior to the beginning of practice.  

If the PPE has been performed 90 days prior to the first day of practice in an athletic season, then the updated HHQ is required.  A physician does not have to complete the HHQ.

IMPORTANT NOTE: Students WILL NOT be allowed to participate in pre-season practice or season games until all required medical forms are on file in the nurse’s office. 

Other Required Forms for Athletes (See: left margin)

1. Archdioces of Newark CYO Athletics Waiver/Code of Conduct (4 pages)

2. Sports Related Concussion Fact Sheet- sign off form (1 page) 

3. Sports Related Eye Injury Fact Sheet

4. Sudden Cardiac Death Sheet-sign off form (1 page)

OTHER HEALTH POLICIES

  • Policy on Administration of Medication (See: School Handbook)
  • Food Policy (See: www.SnackSafely.com) NOTE: ShopRite "School Safe" cupcakes are not free of the top 8 allergens. They contain wheat, soy and dairy and are not safe for all of our children.
  • ​When to Return to School After Illness or Injury (See: School Handbook)