Health Forms and Notices

Completed by school 504 Coordinator, in consultation with the parent and school or OSH nurse, and provided to the student’s bus driver and (if applicable) attendant.

Immunizations and COVID-19 Vaccines

COVID-19 Vaccine Eligibility Letter for Students Ages 5 and Older

• COVID-19 vaccine eligibility letters for students ages 12 and older are available in the following languages, Arabic, Bengali, Chinese, English, French, Haitian Creole, Korean, Russian, Spanish, and Urdu.

COVID-19 Vaccine Eligibility Letter for Students Ages 12 and Older

• COVID-19 vaccine eligibility letters for students ages 12 and older are available in the following languages, Arabic, Bengali, Chinese, English, French, Haitian Creole, Korean, Russian, Spanish, and Urdu.

Guidelines for Entering Student Immunizations into ATS

Health Commissioner Letter to Families Regarding Immunization, April 2024

• Arabic, Bengali, Chinese, English, French, Haitian Creole, Korean, Russian, Spanish, and Urdu

Immunization Chart for Families

• Arabic, Bengali, Chinese, English, French, Haitian Creole, Korean, Russian, Spanish, Urdu

Immunization Guidelines for Schools

Immunization Requirements and Letter

• Arabic, Bengali, Chinese, English, French, Haitian Creole,Korean, Russian, Spanish, Urdu

Letter to Parent - Non-immunized Student Marked Absent

• Arabic, Bengali, Chinese, English, French, Haitian Creole, Korean, Russian, Spanish, Urdu

Medical Exemption Process for Immunizations

Medical Request for Immunization Exemption

Parent Letter for Students not Fully Immunized, October 2019

• Arabic, Bengali, Chinese, English, French, Haitian Creole, Korean, Russian, Spanish, Urdu

Principal Letter for Immunization Policy Update, October 2019

• English
• Additional Frequently Asked Questions About School Vaccination Requirements from New York State Department of Health

Principal Letter for Immunization Policy Update, June 2019

• English
• Frequently Asked Questions About Legislation Removing Non-Medical Exemptions from School Vaccination Requirements from New York State Department of Health

Principal Letter to Families Regarding June 30 Immunization Deadline, April 2021

• Arabic, Bengali, Chinese, English, French, Haitian Creole, Korean, Russian, Spanish, Urdu
  

Parent Letters, Policy Change, for Warnings and Exclusions

Please see the family site for all updates on Immunization Exceptions.

Request for Review of Serology or Documentation of Varicella Disease

SH88 Parents Exclusion Letter (School Year 2024-2025)

• Arabic, Bengali, Chinese, English, French, Haitian Creole, Korean, Russian, Spanish, Urdu

SH89 Parents Warning Letter (School Year 2024-2025)

• Arabic, Bengali, Chinese, English, French, Haitian Creole, Korean, Russian, Spanish, Urdu

SH65 Medical Immunization Requirements

Serology Review Process

Mental Health

Mental Health Resource flyer

• Arabic, Bengali, Chinese, English, French, Haitian Creole, Korean, Russian, Spanish, Urdu

Suicide Prevention Flyer

Mental Health First Aid Handout

"There's Help All Around You" flyer

• Arabic, Bengali, Chinese, English, French, Haitian Creole, Korean, Russian, Spanish, Urdu

Oral Health

Dental Services in New York City Schools

Available Dental Programs One-Pager

School-based Health Center Dental Forms

School-based Health Center Dental Policy and Procedures

Dental Referral Form

• Arabic, Bengali, Chinese, English, French, Haitian Creole, Korean, Russian, Spanish, Urdu

Mobile Oral Health Programs

Starting an Oral Health Program

Picking a Dental Provider

Picking a Dental Space

Dental Visit Prep

Dental Provider Consent Forms

Columbia DentCare Consent Form

• Arabic, Bengali, Chinese, English, French, Haitian Creole, Korean, Russian, Spanish, Urdu

Ezra Medical Consent Form

• Arabic, Bengali, Chinese, English, French, Haitian Creole, Korean, Russian, Spanish, Urdu

First MedCare Consent Form

• Arabic, Bengali, Chinese, English, French, Haitian Creole, Korean, Russian, Spanish, Urdu

NYU College of Dentistry Consent Form

• Arabic, Bengali, Chinese, English, French, Haitian Creole, Korean, Russian, Spanish, Urdu

NYU Langone Consent Form

• Arabic, Bengali, Chinese, English, French, Haitian Creole, Korean, Russian, Spanish, Urdu

Smile NYC Consent Form

• Bengali, Chinese, English, French, Haitian Creole, Korean, Russian, Spanish, Urdu

St. Barnabas Consent Form

• Arabic, Bengali, Chinese, English, French, Haitian Creole, Korean, Russian, Spanish, Urdu

Seizure

Seizure Medication Administration Form (School Year 2024 – 2025)

• English, Arabic, Bengali, Chinese, French, Haitian Creole, Korean, Russian, Spanish, Urdu

Sexual Health

Sexual Health Education Parent Notification Letter

• Arabic | Bengali | Chinese | English | French | Haitian Creole | Korean | Russian | Spanish | Urdu

HIV/AIDS Parent Notification Letter: Grades K - 12

Notifying parents about HIV/AIDS lessons

• Arabic | Bengali | Chinese | English | French | Haitian Creole | Korean | Russian | Spanish | Urdu

Condom Availability Program Parent/Guardian Notification Letter

• Arabic | Bengali | Chinese | English | French | Haitian Creole|Korean | Russian | Spanish | Urdu

HIVAIDS Parent Notification Letter: Grade 6 - 12

Notifying parents about HIV/AIDS and Sexual Health Education

• Arabic | Bengali | Chinese | English | French | Haitian Creole | Korean | Russian | Spanish | Urdu

Sports

Sports History Form and Recommendation for Participation in Physical Education and Sports

• Arabic | Bengali | Chinese | English | French | Haitian Creole | Korean | Russian | Spanish | Urdu

Substance Abuse

Drug Myths and Facts

• Arabic, Bengali, Chinese, English, French, Haitian Creole, Korean, Spanish, Russian, Urdu

Frequently Asked Questions (FAQ): E-cigarettes

• Arabic, Bengali, Chinese, English, French, Haitian Creole, Korean, Spanish, Russian, Urdu

Vision Health

Eye Report and Recommendation Form (E12S)

Vision Screening Policy Statement

Vision Screening Handout

• Arabic, Bengali, Chinese (traditional), English, French, Haitian Creole, Korean, Russian, Spanish, Urdu

Passive Consent Form

• Arabic, Bengali, Chinese (traditional), English, French, Haitian Creole, Korean, Russian, Spanish, Urdu

Vision Pre-screening Letter to Parents

• Arabic, Bengali, Chinese (traditional), English, French, Haitian Creole, Korean, Russian, Spanish, Urdu

Results of Vision Screening Letter

• Arabic, Bengali, Chinese, English, French, Haitian Creole, Korean, Russian, Spanish, Urdu

Results of Vision Screening Follow-Up Letter

• Arabic, Bengali, Chinese, English, French, Haitian Creole, Korean, Russian, Spanish, Urdu

School Trips

• FAQs Regarding School Trips
• Trip Nurse Policy