Medical Registration Forms
2023—2024 School Year
MSD has moved from paper forms to an online registration system. You will access and fill out your child's registration information through PowerSchool. In case you are unable to access some forms online, blank hard copies are provided below on this webpage to print and complete. However, there are some medical forms which will need to be downloaded, printed, and filled out by you and your child's doctor. These medical forms can be found below on this webpage. Should you have any questions or need your parent access id or password, please contact [email protected].
Health Forms (must be printed)
The Registration of Physical Examination form is good for one year.
- Physical Exam Part I (to be completed and signed by a parent or a legal guardian)
- Physical Exam Part II (to be completed and signed by a Healthcare Provider, including the last page which indicates whether or not your child is cleared for sports)
The Immunization Certificate form is to be completed ONLY if recent vaccines were received or if your child is a new student at MSD.
The Blood Lead Testing Certificate form is for all preschool, kindergarten, or first grade students only. This form is to be completed only once.
Other Health Forms to be printed and completed every year if applicable to your child:
One School Medication Administration Authorization form must be completed for each prescription, over-the-counter medication, and supplement/vitamins, etc.
The Asthma Medication Administration Authorization form must be completed if your child has asthma.
The Anaphylaxis Emergency Action Plan must be completed if your child is at risk for anaphylaxis or a severe allergy.
The Diet Modifications for Children with a Food Allergy or Other Disability form must be completed if your child has food allergies or sensitivities.
The Gastrostomy Tube Feeding/Treatment Authorization form must be completed if your child has a G-tube.
The Seizure Action Plan form must be completed if your child is at risk for seizures.
The Catheterization (CIC) Authorization form must be completed if your child needs to be catheterized.
The Diabetes Medical Management Plan form must be completed if your child has diabetes.
The Emergency Action Plan: Sickle Cell Crisis form must be completed if your child has sickle cell anemia.
For More Information
For more information on the Student Health Center services at MSD, please visit www.msd.edu/studenthealthcenter/.
For questions, please contact:
Alyssa Myers, RN | Registered Nurse Supervisor, Columbia Campus
Email: [email protected]
Kimberly Ward, RN | Registered Nurse Supervisor, Frederick Campus
Email: [email protected]