Health Forms

2024/2025 Annual Student Health Forms

Please submit the following annual health records and forms, as needed and indicated by your child’s age and specific health status, prior to your child’s first day of school. Please print the forms from the indicated links, complete, and MAIL (or drop off) to St. Michael’s Country Day School, 180 Rhode Island Ave, Newport, RI, 02840, Attn: School Nurse. Any questions or concerns may be directed to school nurse Kelsey Layfield at klayfield@smcds.org Thank you!

DO NOT EMAIL HEALTH RECORDS

  • ALL families – To be completed by a parent or guardian: 2024/25 Annual Student Health History for each student attending St. Michael’s.
  • ALL families please submit the most recent copy of your child’s RI State Physical Exam form including complete immunization record (the doctor completes and signs this form following each annual exam). Print outs of online portal records are NOT acceptable. Forms are current for 1 calendar year. ALL families must sign a Consent for Emergency Treatment
  • All KINDERGARTEN students are required to have a vision exam provided by either their pediatrician, an optometrist or an ophthalmologist, before the end of September 2024. There is a space on the RI physical Exam record for pediatricians to indicate the exam was completed (exams within one calendar year are current). IF this was not completed on your child’s record, or you have any concerns regarding your child’s vision, contact your physician or seek an appointment with an eye care professional.
  • If your child is entering preschool, prekindergarten, or kindergarten the Physical Exam form should include documentation of lead screening (bottom row of assessments on form). If your child is entering 6th, 7th, or 8th grades, the Physical Exam form should include documentation of scoliosis assessment (bottom line of physical exam record) along with updated required immunizations for 7th and 8th graders (HPV). 7th graders also need a vision screening documented on their physical exam form by physician
  • Medication Orders – To be completed by a parent or guardian AND PHYSICIAN for any student who will  need medication at school and/or on a field trip. 2024/25 Medication Orders & Field trip Student Self-Administration Permission
  • Emergency Health Care Plans (EHCP) -to be completed by a physician and signed by parent/guardian (this link is an example form, a doctor’s specific EHCP orders are an acceptable alternative) are required for any student with a diagnosed severe allergy. If your child is in middle school, the doctor must indicate on the EHCP if the student is allowed to self-carry and self-administer their Epi pen.
  • Asthma Action Plan is required for any student diagnosed with Asthma; physicians must indicate if middle school students are allowed to self-carry and self-administer inhalers. To be signed by both physician and parent/guardian.

Please submit this signed form to your child’s previous school so that St. Michael’s Country Day School may receive your child’s official records. If you have any questions, please contact Sandy Merten, Director of Enrollment, at smerten@smcds.org.

School Nurse 401-849-5970 ext. 389

Last Revised 4/2022

During my visit to St. Michael’s, it was very clear to me that each and every teacher teaches to the...

1st and 3rd Grade Parent

St. Michael's Country Day School
5.0
2019-10-25T09:09:17-04:00

1st and 3rd Grade Parent

During my visit to St. Michael’s, it was very clear to me that each and every teacher teaches to the individual child, not just a group of children. Teachers and St. Michael’s know each and every one of the children they teach and it is obvious that they truly care. 
Everyone here makes an effort to know all of the students. I was amazed when I picked up my son...

Prekindergarten Parent

St. Michael's Country Day School
5.0
2019-10-25T09:09:54-04:00

Prekindergarten Parent

Everyone here makes an effort to know all of the students. I was amazed when I picked up my son from Field Day and everyone – teachers and students alike – all said hello and goodbye to him by name. It feels so amazing to be part of such a 
I love how everyone here is very family oriented and very welcoming. Our family felt part of the school from...

Prekindergarten Parent

St. Michael's Country Day School
5.0
2019-10-25T09:10:30-04:00

Prekindergarten Parent

I love how everyone here is very family oriented and very welcoming. Our family felt part of the school from day one and it made for a really easy transition.
During my daughter’s 2nd grade year, the idea of a Buddy Bench was brought up by a classmate. After presenting...

3rd and 7th Grade Parent

St. Michael's Country Day School
5.0
2019-10-25T09:11:00-04:00

3rd and 7th Grade Parent

During my daughter’s 2nd grade year, the idea of a Buddy Bench was brought up by a classmate. After presenting the idea to the Lower School head, the idea was fully embraced. Instead of just providing a Buddy Bench, my daughter and a few students helped build and decorate the 
St. Michael’s is a magical school. The teachers are wonderful. They have that blend of intelligence, gentle discipline, and love...

2nd Grade Parent

St. Michael's Country Day School
5.0
2019-10-25T09:11:29-04:00

2nd Grade Parent

St. Michael’s is a magical school. The teachers are wonderful. They have that blend of intelligence, gentle discipline, and love inspiring the kids. The sense of community is so evident. The parents are a tight-knit group that truly care about one another and cheer other families one.
5
5
St. Michael's Country Day School

Thumbnails managed by ThumbPress