Rensselaer City School District

• HIPAA Parent Release Form
• NYS School Health Exam Form (Physical)
• RCSD Dental Certificate Form
• School Medical Administration Authorization Form
  • NYSED guide for prescription, OTC, and herbal medications

• Health Registration Form. All students are required to have on file a Health History Registration form, which is typically completed during student registration.
• Immunization Requirements
• Requirements for Physical
• Dental certificates. Poor dental health can cause pain, lead to significant life-long health problems and be a barrier to academic achievement. New York State law requires school districts to request dental certificates for students when they enter school and in grades K, 2, 4, 7 and 10. Please download a form that you can bring to your child’s dental care provider to be completed. The dental assessment may be completed during or 12 months prior to the school year in which it is required. Please return the completed form to your school nurse. If you have questions or do not have a dental care provider for your child, please contact the school nurse for assistance.
• Medications in School: There’s been an important update about how school districts are required to handle over the counter (OTC) medications under New York State guidelines.

  The state classifies: cough drops, Tylenol/Ibuprofen, petroleum jelly and products containing it, including items such as lip balm, lotion, and similar skin care products, as over-the-counter medications. 

  Families who wish for their child to receive OTC medications from the health office, must contact their child’s healthcare provider for the required documentation. Due to this classification, school nurses will not be able to provide these products to students without a current Medication Authorization form.

• Medical Excuses from Physical Education
• Screenings. Vision screening is provided for new entrants and students in grades K-3, 5, 7 and 10. A hearing screening is provided for new entrants and students in grades K, 1, 3, 5, 7 and 10. Parents and guardians will be notified only if a problem is identified.
• Height, weight and body mass index screening. New York state law requires school districts to measure the height, weight, body mass index (BMI), and determine weight status categories for students when they enter school and in grades K, 2, 4, 7 and 10. The purpose of this screening is to detect previously undiagnosed health problems related to growth and development that may, by early intervention, be more readily corrected. School districts also are required to take part in a survey by the New York State Department of Health. Districts will report information about weight status categories gathered from private physicals or school screenings. Only summary information is included in the survey. No names or identifying information about individual students is shared. Information on any child whose parent/guardian has objected to the survey will be excluded from the reported survey data.
• Lead poisoning information. NYS Public Health Law: Title X Part 67 – Lead Poisoning Prevention and Control requires that public schools, daycare providers and nursery schools “obtain evidence” of lead screening for all children under 6. Information on lead exposure and poisoning can be found on the Childhood Lead Poisoning page of the NYS Department of Health’s website.  If you have questions, please contact: 

Rensselaer County Health Department
Lead Program
1600 Seventh Avenue
Troy, NY 12180
Phone: 518-270-2626
Fax: 518-270-2973

• Health concerns. It is the responsibility of the parent or guardian to inform the school of any contagious diseases, changes in health status or unusual health concerns that a child may have. With this information, we are better able to meet the health and safety needs of your child.

Cardiac Emergency Response Annex