Preparing for return to school

Tips to ensure that your child's health needs are met at a school this year

The return to school is an exciting time for students and families. In addition to school supply lists and preparatory visits, parents often request assurance that their child's health needs will be met while at school. There are many components to good health, and students who are healthy are more likely to be ready to learn. Back to school is a unique opportunity for families to evaluate and review their student's individual health care needs and to make the important connection to their school health service provider.

Please note: School entry serves as a "Safety net" to ensure that children have health services in place. It is important for the child's wellness and education that he/she has a primary care provider, dental provider, and health insurance at school entry. If the parent needs assistance in accessing resources, he/she should contact the school nurse.

School nurses are key clinical health providers in the school setting and are a strategic link in meeting the myriad of health needs presented in schools. It is important for parents to learn to know their child's school nurse and to maintain ongoing communications regarding their child's health considerations. This relationship is essential to effective and successful health outcomes during the school day. Because there are a range of health policies across school districts in the Commonwealth, it is important for families to understand both the state and their local school health policies. The following is a brief summary of health information that will assist families in preparing for the return to school.

Physical examinations

Each child needs to present to the school nurse documentation of a physical examination prior to first school entry and at intervals of every three to four years thereafter. If participating in competitive sports, physical exams are required annually.

Reference: Massachusetts School Health Record/Physical Examination Form (DOC) - Parents may wish to share the forms with their child's primary care provider.

Lead poisoning screening

Each child must present documentation of lead poisoning screening upon entry to kindergarten.

Preschool vision screening

Updated Preschool Vision Screening requirements were enacted in 2004. Vision screening should be completed by the student's primary care provider upon entry to kindergarten (within the previous 12 months), or within 30 days of the start of the school year; certification that kindergarteners have passed acuity ( ability to see objects far away) and stereopsis ( how well two eyes work together) screenings is required.

Reference: Preschool Age Vision Screening Protocol  (DOC)


Immunizations are a vital communicable disease control mechanism, and evaluation of current immunization status is recognized as an important checkpoint in determining the student's affiliation with a primary health care provider. State regulations require each child to meet grade entry immunization requirements.

Reference: Massachusetts School Immunization Requirements

Medication administration

When a child requires short-term or long-term medication during the school day, parents are required to contact the school nurse and provide (a) physician's order, (b) parental consent and (c) medication (30 days supply). The administration of medications to children at school is managed by a school nurse with provisions for self-administration of selected medications, as determined by the school nurse. Some school districts have policies related to students carrying medication at school, and it would be prudent for families to learn their district's specific policies.

Reference: 105 CMR 210: The administration of prescription medications in public and private schools

Children with special health care needs

If a child has asthma, allergies, diabetes, seizures, attention deficit disorder, or any other condition requiring special health services in the school and/or is assisted with medical technology, etc., it is vital that the parent meet with the school nurse and develop an Individual Health Care Plan prior to school entry. Physician's orders for care in school will need to be shared with the school nurse. For complex care requiring a team approach, a team meeting before school entry is recommended with the goal that services are in place prior to the start of school so the child is ready to learn.

Emergency planning

School systems require parents to complete Emergency Contact information annually. This is vital information that should be updated whenever changes in contact information occur. There are potentially many emergency circumstances which impact schools. Community emergency planning procedures are developed locally, and it is important for parents to know their specific school/community policies and how they would be notified should an emergency occur.

Safety and injury prevention

The Department provides important safety and injury prevention resources for families.

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