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    Nurse's Notes

     
    Name: Mrs. Patricia Smith                                             
    Email Address: psmith@shoreregional.org 
    Phone number: (732)-222-9300  x2500                                           
     

     
    The goal of the Health Office is to meet your child's needs and provide them with a  welcoming and healthy experience at Shore Regional High School.  Please contact Nurse Smith if your child has a health concern or if you need guidance navigating the health care system.  There are several forms on this website available for your convenience. 

     

    Over the Counter Medication Permission Form 2020:  This permission form needs to be signed by a parent/guardian.  It authorizes the school nurse to administer over the counter medications to your child. 

     

    2020 SRHS Prescribed Medication Permission FormThis permission form needs to be signed by the parent/guardian and your child’s physician.  It authorizes the school nurse to administer prescription medications to your child.

     

     

    Asthma Treatment Plan :  This permission form needs to be signed by the parent/guardian and your child’s physician.  It authorizes the school nurse to administer asthmatic medications to your child at school.

     

    Food Allergy Action Plan:  This permission form needs to be signed by the parent/guardian and your child’s physician.  It authorizes the school nurse to administer medications to treat a food allergy emergency.

     

    Parent/Guardian Permission for Student Self Administration Medication Administration Form:  This permission form needs to be signed by the parent/guardian.  It allows your child to self-administer an inhaler or auto injector medication &/or have the nurse administer the medication.

     

     

    Sports Health History Questionnaire:  must be completed if physical examination was completed more than (90) days prior to the first day of official practice in an athletic season. This form is submitted with a new sports physical.

     

     Sports Physical Form:  Sports Physicals & Sports Health History Forms are submitted to the Health Office.  The sports physical is valid for 365 days from date physical was performed.  Please ensure all sections of the form are completed prior to submission.

     

    COVID SYMPTOMS 

     

    COVID Referral Form 

     

     

    Immunization Requirements:  Click on Immunization Requirements on Health Office home page. 

     

                The school nurse shall conduct the following health screenings:

    Grade 9:          Height, weight, and blood pressure

    Grade 10:        Height, weight, blood pressure, visual acuity, and scoliosis

    Grade 11:        Height, weight, blood pressure, and auditory acuity

    Grade 12:        Height, weight, and blood pressure

               

                Insurance information is available from the school nurse:

    • Low Cost Insurance:  Student Accident Insurance
    • NJ Family Care Program
    • Vision Service Plan:  The school nurse can refer students to this program.  It allows children across the country whose parents work, but are ineligible for government support and cannot afford the eye exams and eyeglasses they need. 

     

    Please contact the school nurse with any questions or concerns you may have with the above information.