Health Room
General Information
Phone: 240-207-2525
Mrs. Madeline Toth Jordan (School Health Room Tech)
Mrs. Jennifer Lichter, RN (School Community Health Nurse)
Important Forms
- MCPS Form 525-12 Authorization to Provide Medically Prescribed Treatment
- MCPS Form 525-13 Authorization to Administer Prescribed Medication
- MCPS Form 525-14 Emergency Care for the Management of a Student with a Diagnosis of Anaphylaxis
- MCPS Form 525-17 Dental Health Card
- MCPS SR-6 Health Inventory Form
- MCDHHS 3213 C School Asthma Management Plan
- MCDHHS 3213 C Plan de Asma
- FS-25 When to Keep Your Child Home From School
-
DHMH FORM 4620 Maryland DHMH Blood Lead Testing Certificate
https://www.montgomeryschoolsmd.org/departments/forms/pdf/dhmh%204620.pdf
DHMH FORM 4620 (Spanish) Certificado de Prueba de Plomo en Sangre del Departamento de Salud Mental e Higiene Mental de Maryland
https://www.montgomeryschoolsmd.org/departments/forms/pdf/dhmh%204620_spanish.pdf
DHMH Form 896 Maryland Department of Health and Mental Hygiene Immunization Certificate
Announcements
