Forms & Downloads

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:

  • Immunization Guidelines 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.