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At the beginning of the school year, every student will receive a Student Emergency Health Record form.

To be able to serve your child in case of sudden illness, accident or emergency evacuation, it is necessary that parents furnish the information requested on the form.  The completed form is kept on file in the health office and is taken from the building during every evacuation drill.  The form is also used to contact parents or other designated care providers in the event your child needs to be sent home.

In order to ensure the safety of all our students, you must complete your child’s form and return it in a confidential envelope.  We must have this essential information for every student enrolled in the school.


Immunizations are required for all newly enrolled students (all grade levels), as well as for all students entering specific grades, including:

  • Pre-Kindergarten
  • Kindergarten
  • Grade 6
  • Grade 7
  • Grade 12

Physical examinations are required for all newly enrolled students (all grade levels), as well as for all students entering these grades:

  • Pre-Kindergarten or Kindergarten
  • Grade 1
  • Grade 3
  • Grade 5
  • Grade 7
  • Grade 9
  • Grade 11

The school nurses, in accordance with the requirements established by the NYS Education Department and school policy, conduct the following screenings annually:

  • Vision
  • Hearing
  • Scoliosis
  • Height and Weight
  • Health Appraisals
  • Pediculosis

The results of these screenings are entered into the student’s cumulative health record. Parents will be notified of findings that are outside of acceptable parameters, which may require professional attention with regard to health.  If you desire information on your child’s screening results, please contact the health office.

*If you do not want your child to be screened at school, please send a written note to the Health Office.


Questions about health forms and related documents?  Call the Health Office, (716) 753-5819.

Forms can be sent to the Health Office's Confidential Fax, (716) 753-2085.


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Google Maps100 North Erie St Mayville, NY 14757 Phone: (716) 753-5800       Fax: (716) 753-5813
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