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Student Allergies, Prescription Medication, and Medical History

Please read the information below and answer the questions regarding your student's allergies, prescription medication, and medical history.



Physical Examination: According to the Massachusetts Department of Public Health (“DPH”), each child needs to present documentation of a physical examination within one year prior to entrance to school or within 30 days after school entry, and at intervals of either three or four years thereafter. If participating in competitive sports, physical exams are required annually

Immunizations: As stipulated by DPH, no student shall attend a preschool, elementary school or secondary school program without a certificate of immunization documenting that the child has been successfully immunized in accordance with current DPH required immunization schedules. However, there are two situations in which children who are not appropriately immunized may be admitted to school: 1) a medical exemption; and 2) a religious exemption. Please note the law states that medical and/or religious exemptions must be submitted at the beginning of each school year.

TDap Immunization: All students entering the 7th grade at BART must show documentation that the Tetanus booster, TDap, has been administered. 


For more information regarding the DPH school requirements, immunizations or exemptions, please visit their website at https://www.mass.gov/service-details/school-health-regulations or contact our School Nurse at 413-743-7311 ext. 728 with any questions or concerns.



Concussions: In accordance with DPH regulations, BART has developed a plan to prevent concussions and provide a safe return to activity for all student athletes after a head injury. BART’s Head Injury and Concussion Policy will ensure that student athletes who experience a concussion are identified and referred to a health care provider for proper concussion symptom management, and do not return to play before they are fully recovered. The athletic director will oversee the implementation of this plan by enforcing the concussion protocols and collecting proper documentation. Please feel free to contact the Athletic Director or School Nurse for a copy of this document.  

School Dismissals: Students will not be allowed to be dismissed from school due to illness, without visiting the School Nurse for assessment. Texting parents for pick-up is against school policy. If it is deemed necessary to dismiss a student from school due to illness, the School Nurse will contact family for student pick-up. 

Peanut/Nut and Fragrance Free: Please see BART’s Student Handbook and review our policies. The Student Handbook can be found on our website or contact our school nurse with questions.

Notifications: A doctor’s note to the nurse’s office is required when a student has:

  • New medication or change in current medication that will be administered at school

  • New medical diagnosis or a change in health status 

  • Serious illness, injury, or hospitalization

  • Fracture, sprain, cast, or sutures; or is using crutches

  • Diagnosis of a contagious disease such as strep throat, conjunctivitis, pertussis (whooping cough), chicken pox, flu, or head lice



  1. The school nurse is the only person authorized to administer medication in school. Other substitute school nurses or designated personnel may be authorized to administer medication in the absence of the school nurse, on a field trip, or in a life-threatening allergy situation. Parents may also come to school to give medication if no cover can be obtained in the absence of the school nurse. 

  2. All prescription medications given at school need a physician order for the medication, a signed authorization from the parent, and a supply of medication in its original pharmacy labeled container. 

  3. Parent must complete the health history form and sign the over-the-counter medication administration authorization at the bottom, in order for the nurse to administer over-the-counter medication to the student.

  4. NO student may carry medication of any kind, prescription or over-the-counter. Asthma inhalers and EpiPens are the exceptions, however, they must be registered in the nurse’s office with physician and parent authorization. 

  5. Medication from discontinued orders or left at the end of the year, will be discarded after 5 school days. It is the parent’s responsibility to pick up leftover medication at the end of the school year. 

  6. On half-days, students with medication scheduled for noon or later will take the medication at home. If there is a school delay or early release, then the parent is responsible for any medication scheduled prior to the delayed start of the school day or after the end of the shortened day.


As mandated by the DPH, the following screenings will be conducted during the school year:

October/November/December March/April

Vision and Hearing for 7th and 10th SBIRT Drug and Alcohol for 7th and 9th Height/Weight/BMI for 7th and 10th Postural Screening for 6th through 9th


All screenings are performed discreetly. If you prefer to have the Vision/Hearing/BMI/Postural screenings performed by your pediatrician, the parent/guardian may notify the nurse in writing. The SBIRT screening may also be declined through a written refusal to the nurse from the parent/guardian or student.

Does this student use an inhaler?
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Does this student use an epiPen
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Health Condition*
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Asthma or breathing problems
Attention-Deficit/Hyperactivity Disorder
Head injury, concussions
Hearing problems or deafness
Heart condition
Lead poisoning
Speech problems
Spinal injury
Vision problems
Urinary/Kidney Issues
High Blood Pressure
Eating disorder
Mood disorder