MEDICAL FORMS (ALL STUDENTS)
Miriam School requires children submit a physical examination form and an immunization record upon enrollment and every three years thereafter. A physician’s statement should be completed for new students and when there is a change in a child’s medical diagnosis. If your physician’s office prefers to use their own physical and immunizations forms, we will accept them.
- Physicians Statement (required for new students and for students with changes of a medical diagnosis)
- Immunization Record (required for new students or every three years for returning students)
- Medical Exam Record (required for new students or every three years for returning students)
- Asthma Action Plan
- Seizure Action Plan
- Food Allergy Action Plan
GRADES K-8
The following required forms must be completed for all incoming lower and middle school students – both new and returning. All forms should be completed for each child no later than the first day of school and updated as changes occur throughout the year.
Parents should use their preassigned PIN number (sent by mail) to indicate they are authorized to submit information regarding their child. Contact the school office at 314.968.5225 with any questions.
- Household Contact Information
- Emergency Medical Information
- Allergy and Dietary Information
- Pick Up Authorization
- School Medication Release
- Home Medication Information
- Handbook Acknowledgement
- Extended Day Enrollment [FULL AS OF 8/23 – CALL TO BE ADDED TO THE WAITING LIST]
- Photo and Video Release
- Technology Responsible Use Acknowledgement
- Pizza Friday Sign Up
- After School Enrichment Class Sign Up (offered by the Learning Center)
GRADES 9-12
The following required forms must be completed for all incoming high school students – both new and returning. All forms should be completed for each child no later than the first day of school and updated as changes occur throughout the year.
Parents should use their preassigned PIN number (child’s birth date) to indicate they are authorized to submit information regarding their child. Contact the school office at 314.962.6080 with any questions.
- Home Medication
- School Medication Dispensing Release
- Pick-Up Authorization
- Photo and Video Release
- Allergy and Dietary Information
- Roster and Household Contact Information
- Field Trip Permission Form
- Pizza Friday Sign Up
- Emergency and Medical Information
- 2021-2022 Early Drop Off Enrollment
- After School Enrichment Class Sign Up (offered by the Learning Center)
