School Nurse's Office
Phone: 301-733-9330 Ext. 3006
Fax: 301-671-2591
Please scan and email completed forms to nurse@stjames.edu.
For more information about Infirmary and health policies visit:
2020-2021 Student Handbook
Immunization Certificate
Print out form here for: Maryland Department of Health and Mental Hygiene Immunization Certificate
PPD-TB Form - This test is now required for all international students. Print form here: PPD-TB Form
View vaccine requirements here: Maryland School Vaccine Requirements
Authorization of Medication Form: This form must be completed fully for the school nurse to administer the required medication. A new medication administration form must be completed at the beginning of each school year, for each medication and each time there is a change in dosage or time of administration of a medication.
Print out the Authorization of Medication form here: 2020-2021 Authorization of Medication Form
Student Care Action Plan Forms:
Allergy Action Plan
Asthma Action Plan
Seizure Action Plan
Diabetes Medical Management Plan
Influenza Permission Form: A new permission form for 2020-2021 for the administering the flu vaccine is coming soon.
Sport's Physical
Print out form for: Sport's Physical
Concussion Clearance Form: Medical clearance for suspected head injury must be completed by a licensed health care provider (LHCP) Provide this form to the health care provider evaluation the student's injury. Return form to the school nurse immediately. If the student is diagnosed with a concussion, the form will be copied by the school nurse and the original form returned to the parent to use at the follow-up visit that clears the student for participation in athletics
Saint James School Concussion Policy
Download and print form here: Concussion Clearance Form
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