Please ensure that all cell phone and emergency numbers are current when you complete the registration forms and are updated as changes are made throughout the school year.

Click on the following links to access the necessary forms. Print and return to the LSS Health Office. Please note that some forms require a healthcare provider’s signature.

• Health Office Information Form: to be filled out at the beginning of each school year for each individual student. The school nurse will use this form and and it be housed in the health office for reference.

• Food Allergy Action Plan: to be filled out if a student has an allergy and needs an EpiPen, antihistamine, or inhaler.

• Special Dietary Medical Statement: to be filled out if a student has food allergies or sensitivities. A healthcare provider’s signature is required.

• Physician’s Request for Medication Administration: to be filled out if a student has a prescription medication to be taken at school. A healthcare provider’s signature is required.

• Physician’s Request for Student’s Self-Possession and Self-Administration of Medication for the School Year: to be filled out if the physician and parent allow a student to carry their own EpiPen and/or inhaler on themselves. A healthcare provider’s signature is required.

• Permission Form for Dispensing Medication in School: to be filled out if a parent/guardian provides the child/student with OTC medication, such as acetaminophen or ibuprofen, to be housed in the health office during the school year.

• Asthma Action Form: to be filled out if a student has asthma. A healthcare provider’s signature is required.

Physical Examinations and Health Screenings

Physical examinations of each student must be completed prior to or upon first entry into the public school system. If you already have a form on file in the health office, that is sufficient unless there are changes from the previous exam. Please submit an updated record if and when your child receives any new immunizations.

For more information about New Hampshire school immunization requirements, visit New Hampshire Department of Health and Human Services HERE.