Prince William County Public Schools

Medications at School

Medication cannot be administered to any student without appropriate authorization forms completed and on file. Any medication must be provided in a new, sealed container with the completed authorization form. Students may not transport medication to and from school. Any medication not meeting the PWCS regulations will not be administered to your student.

In accordance with the Code of Virginia 22.1-274.2 and § 8.01-226.5:1, students diagnosed with asthma or anaphylactic reaction may possess and self administer certain inhaled asthma medications, self-injected epinephrine, or other emergency medication, with the appropriate authorization form on file.

Medical Authorization Forms

Management of Allergic Reactions in the School Setting/School Age Child Care: Administering Epinephrine Auto-Injector Regulation 757-2

Food Allergy and Anaphylaxis Emergency Care Plans must be submitted annually at the beginning of each school/SACC year dated after May 1, and whenever modifications are made to this plan.

• Attachment I: Student Allergy Form (PDF)
• Attachment II: Food Allergy & Anaphylaxis Emergency Care Plan (PDF)
• Attachment III: Parent/Guardian Request for Administration of Medication for Allergic Reactions (PDF)
• Attachment IV: Permission for Student to Carry and/or Self-Administer Epinephrine (PDF)
• Attachment V: PWCS Severe Allergy Individual Health Care Plan (PDF)

Management of Students with Health Treatment Plans Regulation 757-3

• Attachment V: Authorization for Medication Administration (PDF)
• Attachment VI: PWCS Authorization and Consent for Exchange and Release of Medical Information

For a complete list of attachment forms, please view Regulation 757-3.

Management of Medication Administration in the School Setting Regulation 757-4

• Attachment I: Authorization for Medication Administration (PDF)
• Attachment II: Medication Permission Form for Extended Day/Overnight Field Trips-One form for each medication (PDF)

Management of Asthma in the School Setting Regulation 757-5

• Attachment I: Authorization to Implement Health Treatment Plan (PDF)
• Attachment II: Asthma Action Plan (PDF)

Management of Diabetes in the School Setting Regulation 757-6

• Attachment I: Virginia Diabetes Medical Management Plan (DMMP)(PDF)
• Attachment II: Diabetes Treatment Log (PDF)
• Attachment III: Students with Insulin Pumps and/or Continuous Glucose Monitors (PDF)

Management of Epileptic Seizures in the School Setting/School Age Child Care Regulation 757-7

• Attachment I: Seizure Action Plan (PDF)

Immunization Requirements

The following health forms are required for enrolling a student in Prince William County Public Schools.

• School Health Entrance Form Instructions (PDF)
• Commonwealth of Virginia School Entrance Health Form (PDF)
  • Commonwealth of Virginia School Entrance Health Fillable Form (PDF)
  • Commonwealth of Virginia School Entrance Health Form - Spanish (PDF) (Mancomunidad de Virginia Formulario de Salud Para El Ingreso Escolar)
  • Translations can be found on the Virginia Department of Health School Health Forms webpage
• Tuberculosis (TB) Screening Requirements (English) - Regulation 723.4 (Refer to regulation regarding form needed.)
  • Attachment I: Tuberculosis Screening Student Enrollment Form (PDF)
  • Attachment II: High TB Burden Country List 2018 (PDF)
  • Attachment III: Report of Tuberculosis Screening (PDF)
  • Attachment IV: Report of Tuberculosis (TB) Screening and Clearance (PDF)

Athletic Forms: Please refer to the PWCS Student Athletics webpage for additional information. The following forms are needed if a student plans to participate in PWCS athletics.

High School Forms

• High School Physical Exam Form (PDF)
• High School Activities Participation Guide

Middle School Forms

• Middle School Physical Exam Form (PDF)

Health Regulations

• Tuberculosis (TB) Screening Requirements Regulation 723.4
• Physical Examinations Regulation 723-5
• Immunization Requirements Regulation 723-6
• Management of Head Lice in the School Setting Regulation 753-2
  • Attachment I: Facts About Head Lice
  • Attachment II: Head Lice Prevention and Treatment
• Physical Screenings and Testing Regulation 756-1
• Management of Allergic Reactions in the School Setting Regulation 757-2
• Management of Students with Health Treatment Plans Regulation 757- 3
• Management of Medication Administration in the School Setting Regulation 757-4
• Management of Asthma in the School Setting Regulation 757-5
• Management of Diabetes in the School Setting Regulation 757-6
• Management of Epileptic Seizures in the School Setting Regulation-7

Fact Sheets and Other Resources

• Management of Life-Threatening Allergies in Schools and School Age Child Care (PDF)
• Allergy Guidelines (Letter) (PDF)
• Vision and Screening, Scoliosis Fact Sheet (PDF)

Illness or Injury Exclusion Criteria - Reasons for which a child may be sent home from school or for a parent to keep the child home from school.

1. Fever of 100ºF and over - exclude until the student has been fever-free for at least 24 hours.
2. Conjunctivitis (pink eye), strep infections, ringworm, and impetigo are all infections and must be treated with medication for a minimum of 24 hours before returning to school. Please do not allow affected students back before this time so that other students are not infected unnecessarily.
3. Rash of unknown origin (especially if accompanied by a fever).
4. Head injury.
5. Severe coughing or difficulty breathing.
6. Colds - a child with thick or constant nasal discharge should remain home.
7. Diarrhea or vomiting - exclude until the student has been symptom-free for at least 24 hours.
8. Stiff neck associated with a fever and/or a recent injury.
9. Inadequate immunizations with known disease outbreak in school.

Refer to the Virginia Department of Health Communicable Disease Reference Chart for School Personnel (PDF) for other exclusions/information.

The School Health Advisory Board (SHAB) is an advisory group composed of individuals from broad-based segments of the community committed to creating healthy school environments so students may realize their learning potential. The school division generally appoints members of a school health advisory board.

The mission is to advise the school division on issues and programs related to health and healthy lifestyles.

Wellness Plan

What Services Does the School Nurse Provide?

• Annual Health Screening: Vision and hearing screening of all kindergartners, third graders, seventh graders, tenth graders, and newly enrolled PWCS students is conducted each fall by the school nurse and clinic volunteers. This is only a brief screening; parents should continually be alert to identify vision or hearing difficulties that indicate a need for an examination by a specialist.
• Health Services: Assess health and development, provides nursing interventions, and evaluates student responses to care.
• Health Education: Provide health education to students, staff, and parents.
• Healthy Environment: Identify health and safety concerns in the school environment.
• Nutritional Services: Support healthy food services programs.
• Physical Education/Activity: Promote health and physical education which promotes healthy behaviors.
• Counseling/Mental Health: Assess needs, provides interventions and refers students to appropriate staff or community agencies.
• Parent/Community Involvement: Promote community involvement in assuring a healthy school.
• Staff Wellness: Provide health education and wellness programs to school staff.

Code of Virginia Training Required for School Staff

CPR/First Aid/AED: This course addresses the teaching, learning, and working environment is caring, safe and healthy, and values human diversity of the strategic plan. This course is provided for PWCS staff members. Instruction will be provided for a two year ECSI CPR/AED certification and 3 year First Aid certification. Participants will be trained in Standard First Aid and CPR/AED techniques.

Administration of Medication: This course addresses the teaching, learning, and working environment is caring, safe and healthy, and values human diversity of the strategic plan. This course is provided for PWCS staff members designated to be trained by school principals. Attendees must complete the entire program. Successful completion of the Administration of Medication course will help staff safely care for students requiring medication at school. Once the course is completed a school nurse shall provide annual one-hour refresher training for two consecutive years. School staff designated must also attend a refresher course every three years after initial training. Legal reference: Chapter 881, Code of VA, § 55.1-3408, M.

Insulin & Glucagon: This course addresses the teaching, learning, and working environment is caring, safe and healthy, and values human diversity of the strategic plan. This course is provided for PWCS staff members designated to be trained by school principals. Attendees must complete the entire program. Successful completion of the Insulin & Glucagon course will help staff safely care for diabetic students. Once the course is completed a school nurse shall provide annual one-hour refresher training for two consecutive years. School staff designated must also attend a refresher course every three years after initial training. Legal reference: Section § 22.1-274 part E of Code of VA.