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Important Forms


  • On 6/13/19, an amendment to public health law section 2164 passed which eliminates the exemption from vaccinations due to religious beliefs for school attendance. Please see the attached information and guidance from the New York State Department of Health. 
  • Please contact your primary care provider to verify if your immunizations are up to date and schedule appointments accordingly. You can also contact the Wyoming County Health Department to schedule appointments for vaccination at (585) 786-8890. 

Health Examination Form

  • Health exams are required for all students in grades Pre-K, K, 1, 3, 5, 7, 9, and 11, as well as all new entrants and students who want to participate in school-sponsored sports. 

Dental Certificate- OPTIONAL 

Medication Authorization Forms

  • To protect the health and safety of all students, schools must have a written provider order and written parent/guardian consent in order for a student to be administered medication, or to permit a student to self-administer their medication at school. A provider order is required for both prescription and non-prescription medications. A new provider is required for every school year.

Medication Attestation Form 

  • For independent medication carry and use of RAPID ADMINISTRATION MEDICATIONS  (Epi-Pens, Inhalers & Diabetes Medications)

Screening Guidelines

  • Your child will be screened by the school nurse during the school year for vision, hearing, and scoliosis, and is required by NYS Law. If the Health Office has a current physical on file and the physician has performed the required screening, the nurse does not need to screen your child.