Required Medical Forms
DC Medical Forms
In accordance with applicable District of Columbia law, St. Patrick’s makes available here the student Health Forms required for the 2014-2015 school year. Included in this section are:
for vaccine administration. These guidelines are set forth by the CDC and adhered to by the District of Columbia. This form may be given to your healthcare provider at the time of your child’s physical.
District of Columbia Universal Health Certificate Instruction Form
to be given to your healthcare provider at the time of your child’s physical.
District of Columbia Universal Health Certificate
Parents/guardians must complete Sections 1 and 5 of this two-page document. Physician copies of immunization records may be attached to this document.
Human Papillomavirus Information and Refusal Form
to be completed by those parents/guardians who have elected to opt out of the HPV vaccination program by signing a declaration that the parent/legal guardian has been informed of the HPV vaccination requirement and has elected not to participate. Recent legislation requires that both boys and girls enrolling in Grade 6 for the first time at a school in the District of Columbia be vaccinated.
District of Columbia Dental Form
to be completed for all new students entering St. Patrick’s and for all students entering Nursery, Kindergarten, and Grade 4.
St. Patrick's Medication Forms
Also included are the St. Patrick's Over-the-Counter Medication Permission and Permission for Administration of Prescription Medication forms. The St. Patrick’s Over-the-Counter Medication Permission Form must be completed for each child, whether or not you want your child to be administered medications by the School Nurse. Please note that the Over-the-Counter Permission Form requires both a physician's and a parent’s signature in order for the child to be administered any over-the-counter medication.