STUDENT FORMS
The following required forms must be completed for all incoming school students – both new and returning. It is important that the school has up-to-date information about all students, including information regarding medications, allergies, emergency contacts, etc. 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. If you misplace your PIN at any time during the school year, please call the school office and we will retrieve it for you.
- 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
Medical Forms
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
