Health Procedures & Forms

Health Procedures

Students may not possess, dispense, or distribute medication on their own. Prescription medicine must be accompanied with a physician order and dropped off by the parent or guardian. The medicine should be brought to school in the original container and include the name of the medicine, directions for use, time, strength, dose, name of ordering medical provider, and student’s name and grade. At the end of the school year, all medications must be picked up by the parent/guardian by the last day of school. Medicine not picked up will be disposed of.

Students are allowed to carry emergency medication such as an EpiPen or a rescue inhaler but need an order from the doctor allowing them to do so. The form Physician Instructions for Prescribing Medication is used and the box that says student may carry and self-administer medication is checked off.

All over-the-counter medicine provided in the health room is listed on the form Consent for Over-the-Counter (OTC) Medication. This form must be signed by both the parent and health care provider to be valid. The form needs to be renewed every school year.

Procedure for students who become ill during the school day
Students who become ill during the school day should report to their teacher prior to reporting to the health room. If the student’s symptoms are not COVID-related, the student will be given a pass to present to his teacher upon returning to class. Students whose illness cannot be treated expeditiously by the nurse will have their parents notified by the nurse so that they may be picked up and taken home or to their physician. Students may not contact their parents and/or leave campus without release notification by the nurse. If your son drives to school and needs to leave early due to illness, both verbal and written permission from the parents to the nurse is needed to release your son. An email to should be sent by the parent to the nurse allowing their son permission to leave school early and drive himself home. 
Procedure for students who become ill during the school day with COVID-like symptoms: The student will be immediately sent to the nurse, who will bring him to an isolated area in the Health Room for evaluation. The School Nurse will call the student’s parent or guardian.  Students must be picked up from school within 30 minutes of receipt of the call.  If a parent or guardian is not reachable within the first two tries, the student’s emergency contact will be called.  The Maryland Department of Health COVID Decision Aid will be followed for what this student should do and who should be contacted.
All school policies and procedures for COVID-19 are found on our COVID-19 webpage
Students must be kept home for the following:
COVID-19:  Tested positive for COVID-19 in the past 10 days, exposed to someone with confirmed case of COVID in the past 14 days, student has symptoms consistent with COVID-19 according to Maryland Department of Health COVID Decision Aid 
Fever:  If your student has a temperature of >100 degrees orally and no other symptoms, and no known exposure to COVID, the student should be kept at home until he is fever-free for 24 hours without the use of fever reducing medicine such as Tylenol or Ibuprofen.
Vomiting:  Two or more episodes of vomiting in a 24 -hour period, and no other symptoms, the student should be kept home for 24 hours since he last vomited. 
Diarrhea:  Two or more episodes of diarrhea, and no other symptoms, please keep your son home for 24 hours   
Drainage from the eyes:  If your student has drainage from the eyes, associated with conjunctivitis (pink eye) your son must be kept home until under the treatment from a doctor. 

Health Forms

  • Student Physical
    All NEW students are required to submit a summer physical done after May 16, 2021, along with a current immunization record to the school nurse by August 23, 2021.  The health forms should be sent electronically to Mrs. Pam Bezirdjian at or by mail to: Mount Saint Joseph High School, Attention: Health Room, 4403 Frederick Avenue, Baltimore, MD  21229.
    *Physicals done prior to May 16, 2021 will not be accepted.  Students without an immunization record on file the first day of school will not be allowed to attend. 

    Returning sophomores, juniors and seniors do not require an annual physical unless they are playing a sport.  Please continue to update the school nurse for any new medicine, allergies, hospitalizations, and/or medical diagnosis your son has since his last physical.  Please use the front page of the Student Physical form to update changes and email to

    Students playing a sport are required to have a current physical on file with the school nurse prior to tryouts.  Physicals are valid for one calendar year and cannot expire during the sport season.  Please check the athletics page for current announcements regarding our sports programs. 
    If you have any questions or concerns, please contact Pam Bezirdjian, School Nurse, at 410-644-3300 or
  • Immunization Form
    Maryland Department of Health and Mental Hygiene Immunization Certificate (DHMH Form 896) is REQUIRED of all new students.  The form needs to be current and comply with the State of Maryland immunization regulations.  New students must have their current immunization record on file in the Health Room by the first day of school.  Students who do not comply with this will not be allowed to attend classes.  Parents are responsible for providing an updated immunization record and should not rely on their son’s former school for sending over immunization forms.
    *Students who do not have the required vaccinations on the first day of school (i.e. virtual and in-person school) must demonstrate proof of vaccination, positive titer results, or proof of a vaccination appointment to occur within 20 calendar days.
    Vaccines that have a medical exemption must be signed off by a physician or nurse practitioner.
  • Post-Concussion Return to School Form
    This form is to be completed by a health care provider following a concussion diagnosis. The form must be returned to the nurse on the student’s first day back to school.
  • Physician Instructions for Prescribing Medication in School
    This form is mandatory for any student that will need prescription medicine during the school day.
  • Over-the-Counter Medication Consent
    This form is required if you want your son to receive any over-the-counter medicine while in school. The form needs be renewed every year and must be signed by a health care provider as well as the parent to be valid. The school nurse can’t dispense medicine without this form.
  • Food and Allergy Care Plan
Health forms can be submitted by fax to 410-646-6220 or mailed to: Mount Saint Joseph High School, Attention: Health Room, 4403 Frederick Avenue, Baltimore, MD, 21229.

Mount Saint Joseph High School

Mount Saint Joseph is a Catholic, college preparatory school for young men sponsored by the Xaverian Brothers.