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 Karen Kasyjanski, RN

(732) 531-5630 Ext 7010
FAX (732) 531-6561

                                                    

Winter Sports for 6th, 7th & 8th Grades

Cheerleading, Basketball and Wrestling


                                PAPERWORK DEADLINES:

ALL PAPERWORK MUST BE TURNED IN TO THE SCHOOL NURSE FOR REVIEW BY THE FOLLOWING DATES:


October 19, 2017:  EXAM BY SCHOOL DOCTOR

November 01, 2017:  EXAM BY YOUR PRIVATE PHYSICIAN


SPORTS PHYSICAL EXAMS WILL BE HELD AT:

Ocean Township Intermediate School Nurses’ Office,

at no cost to students, with our school physician on the following days:

                    Girls:  Monday, October 23, 2017 at 2:30 pm

                    Boys:  Monday, October 30, 2017 at 2:30 pm


Parents must answer questions 1-54 on page 1 of the History form. If you answer “yes” to any questions on the physical forms, an explanation is required with the date or age of illness or injury.
 ***Incomplete and unanswered paperwork will be returned***


If you choose to use your own physician, our forms must be completed by your child’s physician and the medical exam must be within 365 days prior to the first day of practice. These forms then have to be approved and signed by our school physician before sports participation may begin.
           
****Also, please keep a copy for your records.****


All physical forms can be picked up at nurse’s office or may be downloaded below:  Click on and print:  Athletic Physical Form and/or Interim Health History Update  (see forms below)  Your child will only need the Interim Form if they have had a physical exam conducted within the past 365 days and it is on file with the school nurses’ office. Please contact the nurse’s office if you have any questions at (732) 531-5630 extension 7010.


 

* Please feel free to download and print out forms provided for you below as needed*
Athletic Physical Form
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INTERIM Health History Update - OTIS
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School Health Mandates
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Asthma Treatment Plan - French Creole
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Asthma Treatment Plan - Spanish (scroll to 2nd page for Spanish)
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Parent Fact Sheet on Concussions
Click "More' below for parent information on concussions affecting children and teenagers.
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New Jersey Family Care Insurance Information - English
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New Jersey Family Care Insurance Information - Spanish
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Vaccine Information for Preteens
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6th Grade Vaccination Requirements and Form for Doctor
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Nursing Services Plan 15 - 16
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HPV Vaccine

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Medication Administration Consent Form
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Physician's Standing Orders TOIS 2017-2018
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