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Pelham

Elementary School

Pelham
Elementary Pelham
Memorial Pelham
High School

Forms & Resources

Resources

23-24 New Hampshire School Immunization Requirements

24-25 New Hampshire School Immunization Requirements

Cardiac Chain of Survival

Disease Handbook from the Department of Health and Human Services

Parent Health Watch

Stay Healthy Poster

Information Regarding Immunization Exemption

Religious Exemption Form

Forms

Anaphylaxis Emergency Care Plan
Use this form to document a plan for your child in case of a severe allergic reaction.

Self Carry Form
This form needs to be filled out by the physician, parent and middle school nurse if your child will be self-carrying their inhaler and/or EpiPen.

Over The Counter Medication Form
Fill out this form if the child needs to have over the counter medications during the school day. Examples would be Tylenol, Ibuprofen, cough drops. Parents must supply the medication in the original bottle and students cannot transport medications.

Physician Medication Form
To be completed for any prescription medication required during the school day. Must have a parent signature on the top portion and the physician signature on the bottom. All medication must be brought in original pharmacy bottled and by an adult.

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