Nurse’s Forms – Centreville Layton School

Source: https://centrevillelayton.org/nurses-forms

Archived: 2026-04-23 17:13

Nurse’s Forms – Centreville Layton School
Nurse’s Forms
Please find all of the required forms for your child’s enrollment below. If you have any questions, please feel free to email the school nurse,
Regina Bryant.
The
Centreville Layton School Emergency and Medical Information Card
must be filled out each year for the coming school year. This form is required if your child needs to be seen by the nurse, or in the event your child needs to be transported to the hospital.
All Students in the Lower School are required to fill out a
Delaware Student Health Form – Children PreK – Grade 6
every 2 years.
Your child’s Immunization Record must be attached. This record must be current as required by Delaware state law. Please review your child’s record with your pediatrician to make sure all immunizations are up-to-date.
All Students in 7-12th grades must submit a
DIAA
Physical
each year, regardless of athletic team intentions. Your child’s current immunization record must be attached to this physical.
If your child will be taking any prescription medication during the school day, or over-the-counter medication that is not kept in stock, you must complete the enclosed
Parental Request to Have Medication Administered in School Form.
Please bring in the medication and completed form and leave them with Diane Daiger at the front office or give directly to
Regina
Bryant, school nurse.
If your child has a severe allergy and uses an epi-pen, you must provide the school with the epi-pen(s) and the
Prevention and Emergency Response Plan for Students with Allergies
filled out by your child’s physician. The school Nurse’s Office stocks diphenhydramine (Benadryl) for these emergencies. Epi-pens are kept in a central location at the school that all staff members have access to in case of an emergency.
If your child is an asthmatic, you must provide a rescue inhaler and/or inhalation solution to be kept in the Nurse’s Office for emergencies. If your child has asthma, you must return the
Asthma Action Plan
filled out by your child’s physician.
If your child has a history of seizures, you must complete our
Seizure Action Plan
.
The
TB Risk Assessment
must be completed by all 9th grade students and any Middle or Upper School students who are new to CLS this year. Please let us know if you have any questions.
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Our son learned the valuable skills of teamwork, patience and perseverance during his time at Centreville Layton as well as the academic strategies to move forward into a typical high school setting. Centreville Layton strikes a great balance of family-like warmth and discipline in a beautiful country setting.
Jan B.
Former Parent
This past year has been completely transformational for our daughter and her positive strides have been noticeable both at home and at school. She is growing into the best version of herself and her teachers at CLS have played a significant role in her progress.
Michelle L.
Middle School parent
This year, I’ve learned to understand that acceptance is greatly appreciated but difficult to find. Compared to where I came from, CLS houses some of the most accepting people that I’ve ever met. I am thankful for every little act of kindness shown towards me or even towards another student. They have not gone unnoticed.
SB
Student
We’re prepared for this because we’ve learned how to work hard, solve problems, be independent, happy, responsible and kind to all.
Student
Student
The support from my teachers taught me not just reading and writing, but to embrace who I am, to learn from my mistakes and grow because of them.
TL
Student