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1. Page 2 of 4 PHYSICAL EXAM STUDENT S HEALTH HISTORY page 1 of this form REVIEWED PRIOR TO PERFOMING EXAMINATION Yes O O Physical exam for grade 60 11 Other O CHECK ONE NORMAL ABNORMAL DEFER ABNORMAL FINDINGS RECOMMENDATIONS REFERRALS Height inches Weight pounds BM BMI for Age Percentile Pulse Blood Pressure Hair Scalp Skin Eyes Vision Corrected O Ears Hearing Nose and Throat Teeth and Gingiva Lymph Glands Heart Lungs Abdomen Genitourinary Neuromuscular System Extremities Spine Scoliosis Other TUBERCULIN TEST DATE APPLIED DATE READ RESULT FOLLOW UP MEDICAL CONDITIONS OR CHRONIC DISEASES WHICH REQUIRE MEDICATION RESTRICTION OF ACTIVITY OR WHICH MAY AFFECT EDUCATION Additional space on page 4 Print name of examiner Parent guardian present during exam Yes O Print examiner s office address Signature of examiner Physical exam performed at Personal Health Care Provider s Office School O Date of exam 20 Phone MDI DOI O Page 3 of 4 IMMUNIZATION HISTORY HEALTH CARE PROVIDERS Please photocopy immunization history from student s record insert information below IMMUNIZATION EXEMPTION S2. H514 027 08 201 1 under review COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF HEALTH PRIVATE DENTIST REPORT OF DENTAL EXAMINATION OF A PUPIL OF SCHOOL AGE NAME OF SCHOOL DATE 20 NAME OF CHILD AGE SEX GRADE SECTION ROOM E Last First Middle M F ADDRESS No and Street City or Post Office Borough Township County State Zip REPORT OF EXAMINATION TOOTH CHART RIGHT LEFT 11234506 7181910110111 12 13 14 15 16 UPPER J Upper 32 31 30 29 28 27 26 25 24 23 22 21 20 19 18 17 LOWER 5 NM LK Lower UPPER Upper LOWER Lower Is The Child Under Treatment Yes OI Treatment Completed Yes O Date of Dental Examination Signature of Dental Examiner Print Name of Dental Examiner Address Sapphire Parent Welcome Letter The South Eastern School District implemented a new Student Information System called Sapphire in 2014 2015 This is a real time integrated system that shares data between departments Parents will be able to use one account to see attendance schedules grades announcements and student information for all their children We are able to provide you with more information and work toward becoming more paperless Registration is easy and instructions are listed below If you registered last year your account information and passwords
3. 3 Contact Number for the person completing this form 4 The student lives with Check all that apply Parent s or legal guardian Relative friend s or other adult s O Alone O Other 5 Contact person at school last attended if known Signature of Parent Legal Guardian or individual enrolling child Date SESD 71 06 15 SOUTH EASTERN SCHOOL DISTRICT Verification Under 24 P S 13 1304 A Parental Registration Statement Sworn Statement Student Name Date of Birth Grade Parent or Guardian Name Address Telephone I hereby verify that my child has orhasnot been previously suspended expelled from any public or private school in Pennsylvania or elsewhere for an act or offense involving weapons alcohol or drugs or for the willful infliction of injury to another person or for any act of violence committed on school property I acknowledge that the foregoing statements are true and that the statements are made subject to the penalties of 18 Pa C S 4904 b relating to penalties for unsworn falsifications to authorities Signature of Parent or Guardian Date II Supporting Information Complete this section if the child was previously Suspended or expelled for any offenses listed in Section I Name of School Reason s for Suspension Expulsion Date of Suspension Expulsion SESD 47 6 03 South Eastern Sc
4. 7 Had h TA 33 Name of student s dentist r nt m ram n rcising aT EA SUE Last dental visit less than 1 year 1 2 years greater than 2 years HEAD NECK SPINE Has the student YES NO SOCIAL LEARNING Has the student YES NO 8 Had headaches with exercise 9 Ever had a head ini pesa 34 Been told he she has a learning disability intellectual or Even nad is OR CONCUSSION developmental disability cognitive delay ADD ADHD etc 10 Ever had a hit or blow to the head that caused confusion prolonged 35 Been bullied or experienced bullying behavior headache or memory problems HER meae 36 Experienced major grief trauma or other significant life event 11 Ever had numbness tingling or weakness in his her arms or legs after being hit or falling 37 Exhibited significant changes in behavior social relationships 12 Ever been unable to move arms or legs after being hit or falling 38 grados or seepirg mawn tom famiy Dr ienes 13 Noticed or been told he she has a curved spine or scoliosis ao ee SUUM Mue 2 L etme 14 any problem with his her eyes vision or had a history of an shown a general loss E energy motivation interest or sni usiasm eye injury 40 Had concerns about weight been trying to gain or lose weight or received a recommendation to gain or lose weight 15 Been prescribed glasses or contact lenses
5. Signature of Parent Guardian Date Reviewed by Please complete side two of this form SESD Revised 4 2014 Please circle YES NO If yes please explain A Pre Natal Health History 1 Was the baby born prematurely NO YES 2 Were there any complications during the pregnancy NO YES 3 Did the mother take any medications drugs during the pregnancy NO YES B Developmental History 1 What was the baby s birth weight 2 Did the baby have any concerns while in the hospital NO YES 3 Did the baby have any special problems in the first six months NO YES 4 Were there any concerns with the development of your child NO YES 5 Were there any speech concerns with your child NO YES 6 Can the child use the toilet without help NO YES C Family Health History 1 Circle any of the following diseases that this child s parents grandparents aunts uncles brothers or sisters have a history of Vision Problems Hearing Problems Learning Problems Social Emotional Problems Other 2 Please share any concerns you have about your child s health or behavior Assessment of Student Health To the best of your knowledge has your child had any problem with the following Please check yes or no Condition Yes No Comments Allergic Reaction Severe Allergies Food Insect Drugs Latex Allergies Environmental Seasonal Asthma or Breathing Problems Behavior or Emotion
6. Medical Date Issued Reason Date Rescinded Medical Date Issued Reason Date Rescinded Medical Date Issued Reason Date Rescinded NOTE The parent guardian must provide a written request to the school for a religious or philosophical exemption VACCINE DOCUMENT 1 Type of vaccine 2 Date month day year for each immunization T 3 4 5 Diphtheria Tetanus Pertussis child Type DTaP DTP or DT Diphtheria Tetanus Pertussis adolescent adult Type Tdap or Td T 3 4 5 Polio Type OPV or IPV T 3 4 5 Hepatitis HepB T 3 4 5 Measles Mumps Rubella MMR Mumps disease diagnosed by physician 0 Date T 3 4 5 Varicella Vaccine O Disease T 3 4 5 Serology Identify Antigen Date POS or NEG i e Hep B Measles Rubella Varicella T 3 4 5 Meningococcal Conjugate Vaccine MCV4 T 3 4 5 Human Papilloma Virus HPV Type HPV2 or HPV4 T 3 4 5 Influenza 5 g 3 10 TIV injected LAIV nasal gt T3 T4 To T 3 4 5 Haemophilus Influenzae Type b Hib T 4 5 Pneumococcal Conjugate Vaccine PCV Type 7 or 13 T 4 5 Hepatitis A HepA T 3 4 5 Rotavirus Other Vaccines Type and Date Page 4 of 4 ADDITIONAL COMMENTS PARENT GUARDIAN STUDENT HEALTH CARE PROVIDER
7. 1 118 24673 99 31 prior consent for disclosure not required a An educational agency or institution may disclose personally identifiable information from the education records of a student without the written consent of the parent of the student or the eligible student if the disclosure is 1 to other school officials including teachers within the educational institution or local educational agency who have been determined by the agency or institution to have legitimate educational interests 2 to officials of another school or school system in which the student seeks or intends to enroll subject to the requirements set forth in 99 34 The above information is to be sent to Delta Peach Bottom Elementary School Fawn Area Elementary School L Stewartstown Elementary School 1081 Atom Road 504 Main Street 17945 Barrens Road North Delta PA 17314 Fawn Grove PA 17321 Stewartstown PA 17363 Fax 717 456 6042 Fax 717 382 1326 Fax 717 993 5256 ir South Eastern Intermediate School South Eastern Middle School Kennard Dale High School 417 Main Street 375 Main Street 393 Main Street Fawn Grove Pa 17321 Fawn Grove PA 17321 Fawn Grove PA 17321 Fax 717 382 4786 Fax 717 382 9033 Fax 717 382 4258 PLEASE FORWARD THIS FORM OR A COPY WITH THE STUDENT RECORDS SESD 45 06 15 SOUTH EASTERN SCHOOL DISTRICT STUDENT RESIDENCY QUESTIONNAIRE Dear Parent or Guardian Your responses to these questions will help staff deter
8. CHILD BIRTHDATE GRADE REQUIRED EXAMINATIONS Pennsylvania State Law under the School Health Code requires Physical Examination for original entry Pre K K or 1st Grades 6 amp 11 Dental Examinations for original entry Pre K K or 1st Grades 3 amp 7 EXAMINATIONS Physical Examinations The School Health Act of Pennsylvania requires a physical examination for all children in grades 6 amp 11 and all new students entering South Eastern School District whose records do not include a physical examination This required exam may be dated one year prior to the start of school or sooner Your family physician or school physician may meet the requirement I plan to have my child s physical examination done by our family physician Schedule my child s physical examination with the school physician Dental Examinations The School Health Act of Pennsylvania requires a dental examination for all children in grades 3 amp 7 and all new students whose records do not include a dental examination This required exam may be dated one year prior to the start of school or sooner Your family dentist or the school dentist may meet the requirement I plan to have my child s dental examination done by our family dentist Schedule my child s dental screening with the school dentist complete a Mobile Dentist registration form SCREENING TESTS Pennsylvania State Law under the School Health Code requires screening tests for Gro
9. NO I DO NOT want my child to be given potassium iodide when instructed by public heath officials in the event of a radioactive emergency during school hours PLEASE NOTE The best protective action in a radiation emergency is evacuation Standing Order Medications School personnel have my permission to use the first aid supplies listed in the student handbook and the non prescription medications listed below to treat my child as needed Please check the items below that health room staff may give to your child during the school day Antacid liquid or tablet Generic Tylenol Cough Drops X Generic Advil Motrin Generic Zyrtec to treat allergy symptoms All non prescription medications listed above will be administered by appropriate weight or age School personnel have my permission to transport or to make arrangements for transportation of my child to emergency medical care in the event that the persons listed cannot be contacted Parent Guardian Signature PARENTS ARE RESPONSIBLE TO NOTIFY THE SCHOOL AS SOON AS POSSIBLE OF ANY CHANGES IN HEALTH IMMUNIZATION STATUS OR CONTACT INFORMATION PLEASE TURN OVER TO FINISH COMPLETING INFORMATION ANNUAL HEALTH HISTORY Student Name TO THE PARENT OR GUARDIAN The information requested on this form will be of help to the school nurse in determining the health status of your child The information provided will be kept confidential and shared with school staff and bus driver
10. STUDENT OR RESTRICT ACCESS TO STUDENT Immigrant Yes No Education in US School since Not attend US schools more than 3 full years Home Language Has your child ever received remedial tutoring or special education services Yes No If yes please circle the type s below and provide dates of service From To IEP Autistic Learning Support LS Occupational Therapy OT Emotional Support ES Life Skills Support LSS Physical Therapy PT Gifted Support GIEP Multiple Disabilities Support MDS Hearing Impaired Support HIS Vision Impaired Support VIS Speech Language Support SLS Neurologically Impaired Support NI Title I 504 Plan Service Agreement Other If the student is currently receiving services please provide a copy of the program and the contact information Parent Guardian Signature BIRTH RECORD VERIFICATION STUDENT RESIDENCE VERIFICATION BIRTHDATE TYPE OF VERIFICATION BIRTHPLACE CERTIFICATE NO SESD 41 Revised 5 13 15 South Eastern School District Fawn Grove Pennsylvania 17321 PROGRAMS FOR LIMITED ENGLISH PROFICIENCY STUDENTS Student Home Language Survey Date Student Name First Middle Last School Date of Birth Age Address Parent Guardian Name please print Parent Guardian Signature 1 Is your family and child s first language English Check one of the following Yes If yes stop survey here No If no please conti
11. South Eastern School District Delta Peach Bottom Elementary School Student Registration Packet Please call 717 456 5313 ext 5800 to set up an appointment In addition to the completed Registration Packet please bring along the following pieces of information e Two proofs of residency verifications driver s license lease bill with printed address e Birth Certificate e Immunization Record e Grade Report from Previous School e Custody Paper if applicable e IEP or 504 Plan if applicable South Eastern School District Fawn Grove Pennsylvania 17321 Student Registration Census Form For Internal Use Only Grade Enrollment Date Enrollment Code Student ID Date of Withdrawal Date of Graduation STUDENT INFORMATION Student s Name Last First Middle Jr IV Address Street City State Zip Township Borough Home Phone Cell Phone Birth Date Place of Birth Gender Attendance Notification Initial US Entry Date if ELL School Last Attended if applicable District Residence Date PA Residence Date School Entry Date Address Phone PARENT GUARDIAN INFORMATION 1st CONTACT 2nd CONTACT 3rd CONTACT Relationship to Student Relationship to Student Relationship to Student ex Father Mother Stepparent ex Father Mother Stepparent ex Father Mother Stepparent E Enter NA after a te
12. WEST cohok ord 5 Used or currently uses tobacco alcohol or drugs HEART LUNGS Has the student vES NO y usos g T FAMILY HEALTH YES NO 16 Ever used an inhaler or taken asthma medicine US 17 Ever had the doctor say he she has a heart problem If so check of ihe folowing 50 check all that apply all that apply Heart murmur or heart infection Anemia blood disorders Inherited disease syndrome High blood pressure Kawasaki disease Asthma lung problems Kidney problems High cholesterol Other Behavioral health issue Seizure disorder 18 Been told by the doctor to have a heart test For example Diabetes 1 Sickle cell trait or disease ECG EKG echocardiogram Other 19 Had a cough wheeze difficulty breathing shortness of breath or 43 Is there a family history of any of the following heart related felt lightheaded DURING or AFTER exercise problems so check that apply 2 Had discomfort pain tightness or chest pressure during exercise O Brugada syndrome QT syndrome L1 Cardiomyopathy Marfan syndrome 21 Felt his her heart race or skip beats during exercise High blood pressure Ventricular tachycardia BONE JOINT Has the student YES NO High cholesterol Other 22 Had a broken or fractured bone stress fracture or dislocated joint 44 Has any family member had unexplained fainting unexplained 23 Had an injury to a muscle ligament or tendon s
13. al Problems Birth Defects Bleeding Problems Cerebral Palsy Chicken Pox Disease Cystic Fibrosis Developmental Problems Diabetes Ear or Hearing Problems Eating Disorders Eye or Vision Problems Growth Disorder Head Injury Concussion Heart Problems High Blood Pressure Hospitalization Why When Kidney Urinary Problems Lead Poisoning Exposure Limits on Physical Activity Meningitis Orthopedic Bone Problems Seizures Sickle Cell Disease Speech Problems Stomach Intestinal Problems Tumors Cancer Other Please Explain Please contact the School Nurse if you have any concerns regarding your child that you would like to discuss Parent Guardian Signature Date 511 336 Rev 9 2012 Page 1 of 4 STUDENT HISTORY Ge pennsylvania d DEPARTMENT OF HEALTH Bureau of Community Health Systems Division of School Health Student s name Private or School PHYSICAL EXAMINATION PARENT GUARDIAN STUDENT Complete page one of this form before student s exam Take completed form to OF SCHOOL AGE STUDENT appointment Today s date Date of birth Age at time of exam Gender Male Female Medicines and Allergies Please list all prescription and over the counter medicines and supplements herbal nutritional the student is currently taking Medic
14. cial Position Date PSC 1305 A Requires the receiving school district in the state of Pennsylvania to request certified disciplinary records from a student s former school district Please accept this form as a request for certified disciplinary records 1 Student s Name Grade Date of Birth Date enrolled at South Eastern School District 2 I hereby give permission for Name of Previous School to release the following information to South Eastern School District for above named student s It is my understanding that all information will be utilized only by professional personnel to aid my child in his her education program Title I ____ Psychological Psychiatric Evaluations A Cumulative File Date _ Reading Recovery Comprehensive Evaluation Report ER Health Dental Immunization Records IST ____ Individual Educational Program IEP ____ Discipline Records weapons drugs 504 Plan A Notice of Recommended Educational drug alcohol violence Other Placement NOREP Standardized Test Scores Pa Secure ID Report Cards or Grades to Date Mutual Exchange of Information including school counselors school nurse teachers and administrators Signature of Parent Guardian Surrogate Parent Date IT IS NOT NECESSARY FOR PARENTS TO SIGN A RELEASE WHEN RECORDS ARE BEING PASSED FROM PUBLIC SCHOOL TO PUBLIC SCHOOL Note Federal Register Part II HEW Privacy Rights of Parents and Students Vol 4
15. eizures or experienced a near drowning 24 Had an injury that required a brace cast crutches or orthotics 45 Has any family member relative died of heart problems before age 25 Needed an x ray MRI CT scan injection or physical therapy 50 or had an unexpected unexplained sudden death before age following an injury 50 includes drowning unexplained car accidents sudden infant M 7 death syndrome 2 Had joints that become painful swollen feel warm or look red QUESTIONS CONCERNS YES NO SKIN Has the student YES NO 46 Are there any questions or concerns that the student parent 27 Had any rashes pressure sores or other skin problems guardian would like to discuss with the health care provider If 28 Ever had herpes or a MRSA skin infection yes write them on page 4 of this form hereby certify that to the best of my knowledge all of the information is true and complete give my consent for an exchange of health information between the school nurse and health care providers Signature of parent guardian emancipated student Date Adapted in part from the Pre participation Physical Evaluation History Form 2010 American Academy of Family Physicians American Academy of Pediatrics American College of Sports Medicine American Medical Society for Sports Medicine American Orthopaedic Society for Sports Medicine and American Osteopathic Academy of Sports Medicine
16. hool District New Entrant Student Emergency Card Student Name Is your student covered health insurance __Yes__No dental insurance Yes vision insurance Yes Potassium lodide Program South Eastern School District participates in the Pennsylvania Department of Health Potassium lodide program Should a radiation emergency occur the media would broadcast official recommendations to the public for protective actions including the possible use of KI Distribution through the school system is being given high priority for the reason that children are much more sensitive to the ill effects of radioactive iodine than are adults KI should NOT be taken by anyone who is allergic to iodine A fact sheet is included in the Student Handbook or by contacting the Pennsylvania Department of Health at 1 877 PA HEALTH or visiting the website at www health state pa us Please place a check beside one of the following ___ YES DO want my child to be given potassium iodide when instructed by public health officials in the event of a radioactive emergency during school hours South Eastern School District will make a reasonable attempt at supervising students taking the KI tablet and will not be held liable for any adverse reactions to the KI tablet release the South Eastern School District its administrators employees faculty and staff from the voluntary participation of my child in the distribution effort
17. ines Pollens Does the student have any allergies Yes If yes list specific allergy and reaction L1 Food L1 Stinging Insects Complete the following section with a check mark in the YES or NO column circle questions you do not know the answer to GENERAL HEALTH Has the student YES NO GENITOURINARY Has the student YES NO 1 Any ongoing medical conditions If so please identify 29 Had groin pain or a painful bulge or hernia in the groin area Asthma Anemia Diabetes O Infection 30 Had a history of urinary tract infections or bedwetting Other 31 FEMALES ONLY Had a menstrual period 1Yes 2 Ever stayed more than one night in the hospital If yes At what age was her first menstrual period 3 Ever had surgery How many periods has she had in the last 12 months 4 Ever had a seizure Date of last period 5 Had a history of being born without or is missing a kidney an eye a DENTAL YES NO i tosticle males SDIBSI r Any otherorgan 32 Has the student had any pain or problems with his her gums or teeth 6 Ever become ill while exercising in the heat n
18. lephone number to exclude it from the districts School Reach notification system TRANSPORTATION INFORMATION If Parent s Work Babysitter s Name Babysitter s Address Babysitter s Telephone Number Provide location where child will board bus Bus Assigned Bus Stop SESD 41 Revised 5 13 15 LIST OTHER CHILDREN RESIDING AT PARENT GUARDIAN ADDRESSES LAST NAME FIRST DATE OF RELATIONSHIP TO LAST SCHOOL NAME MIDDLE NAME BIRTH PARENT GUARDIAN GENDER RESIDES WITH ATTENDED IN ADDITION TO THOSE LISTED ABOVE LIST OTHER INDIVIDUALS OVER THE AGE OF 18 RESIDING AT PARENT GUARDIAN ADDRESSES LAST NAME FIRST NAME MIDDLE NAME OCCUPATION PLACE OF EMPLOYMENT Family Physician Family Dentist Part 1 Ethnicity choose one Hispanic Latino Not Hispanic Latino Part 2 Race choose one or more regardless of ethnicity American Indian Alaskan Asian Black or African American Native Hawaiian or Other Pacific Islander White Student resides with Both parents Mother Father Joint Custody Parent amp Stepparent Foster Parent Circle all that apply Grandparent Agency Relative Children s Home Other If student resides with other indicate name and relation to the child Status of adult with whom student resides Single Married Separated Divorced Widowed Living Together Date of most current Court Orders Custody Decrees PLEASE PROVIDE A COPY OF ANY COURT ORDERS CUSTODY DECREES THAT PERTAIN TO
19. mine what residency documents are necessary for enrollment of your child ren and further help us determine if we have additional resources we can offer you and your family Thank you for your cooperation 1 Student Name Birth Date Person completing form Relationship to child 2 In what type of setting is the student living now Check one box below SECTION A SECTION B nan emergency or transitional shelter Sharing the housing of other persons due to loss of housing economic hardship or similar reason O motel hotel campsites cars due to a lack of alternative adequate accommodations In a car park public spaces abandoned building substandard housing bus or train stations or similar settings Other places not designed for or ordinarily used as a regular sleeping accommodation for human beings CONTINUE to Section C if you checked any box in this section LI None of the choices in Section A apply If you checked this section you do not need to complete the remainder of this form Submit the form to school personnel now after signing the reverse side SECTION C e What was the event that caused your family to move e Do you consider this living situation to be a temporary situation or something more long term SESD 71 06 15 Please Explain When was the last day your son daughter was enrolled in school
20. nue survey 2 What language s does your child speak most often at home 3 What language s do you use when speaking to your child 4 What language s is spoken most often in your home 5 What language s does your child read 6 What language s does your child write 7 Does your child understand but not speak a language other than English Please list any other Schools your child has attended in the United States School Years The Civil Rights Law of 1964 Title VI requires that school districts charter schools identify limited English proficient LEP students Pennsylvania has selected the Home Language Survey as the method for the identification All students enrolled in our District are required by the Pennsylvania Department of Education to complete the following survey On behalf of your child please complete and return to your child s school Thank you for your assistance SESD 55 6 2013 SOUTH EASTERN SCHOOL DISTRICT 377 Main Street Fawn Grove PA 17321 Permission to Release Student Information PLEASE FORWARD THIS FORM OR A COPY WITH THE STUDENT RECORDS For disciplinary records please check the appropriate box Certified disciplinary record enclosed LI Student has no disciplinary record The signature of the following individual certifies the disciplinary records enclosed are the true and accurate discipline records of the student indicated below School Offi
21. s only when the school nurse and or school physician believes that it is in the best interest of your child s health safety and education Please feel free to contact the school nurse if you have any questions or information you wish to share CIRCLE YES or NO 1 SHOULD YOUR CHILD BE RESTRICTED FROM PARTICIPATION IN SCHOOL SPORTS OR GYM YES NO If yes please provide recommendations from your physician in writing 2 DOES YOUR CHILD REQUIRE A SPECIAL DIET YES NO If yes please specify W HAVE THERE BEEN ANY CHANGES IN YOUR FAMILY DURING THE PAST YEAR WHICH MAY AFFECT YOUR CHILD YES NO If yes please explain 4 DOES YOUR CHILD a have trouble seeing YES NO b need to wear glasses contacts lenses YES NO If yes please X all that apply Needed for Constant Wear Near Vision Distant Vision c have trouble with ears or hearing YES NO d need to wear hearing aids amplification system YES NO e is preferential seating required YES NO 5 DO YOU HAVE ANY CONCERNS REGARDING YOUR CHILD TO DISCUSS WITH THE SCHOOL NURSE If yes please call to set up an appointment YES NO My signature below indicates that I have read and understand the information on both sides of this form Date Signature of Parent Guardian On behalf of the School Health Services thank you for taking time to complete this important update of your child SOUTH EASTERN SCHOOL DISTRICT K 6 Grade Student Health History NAME OF
22. stay the same and you will not need to register again Step 1 Prepare You must have an email account in order to create an account If you do not have an email account there are many free email sites such as mail yahoo com and mail google com You will need to data enter the grades and birth dates of your children so they will be linked under one account Step 2 Create your parent account Any legal guardian who wishes to access the system should create an account e Go to www sesdweb net Click Parent Click Sapphire Click Community Portal Click Community Portal Application and Acceptable Use Policy Form Enter keyword sesdsapphire Read the user agreement Click Yes Click Continue Enter applicant children and login information Click Save Form and Continue If desired you may print a copy of the form for your records You will automatically receive an email with your form details When your form is approved you will receive an email notification with your pin We anticipate approval will take up to five business days at the start of school year Forms should be processed in less than 24 hours after the initial set of requests are processed Record your username password and pin and store it in a safe location Your account will remain active as long as you have children enrolled in the district You do not need to create a new account each year Step 3 Log into Sapphire after you receive your pin e Go to ww
23. w sesdweb net Click Parent Click Sapphire Click Community Portal Enter username password and pin Frequently Asked Questions If you forget your password click on the Forgot your password link on the login page Your password will be emailed to you If you forget your pin email the Help Desk at techsupp sesd k12 pa us or call 717 382 4843 x6333 The user manual and any other related information can be found at the following link http www sesdweb net sapphireparentinfo
24. wth amp Vision Pre K 12 Hearing Pre K 3 7 amp 11 and Scoliosis 6 amp 7 The School Nurse will complete these screening tests and inform parents guardians of abnormal results IMMUNIZATION REQUIREMENTS A copy of your student s immunization record is required at time of registration Children in ALL grades K 12 need the following vaccines TETANUS 4 doses 1 dose on or after 4 birthday DIPTHERIA 4 doses 1dose on or after 4 birthday POLIO 3 doses MEASLES 2 doses MUMPS 2 doses RUBELLA 1 dose German measles HEPATITIS B 3 doses VARICELLA evidence of Immunity or 2 doses chickenpox Usually given as DTP DT or Td Usually given as MMR The only exemptions to the school law for immunizations are medical reasons religious beliefs or philosophical strong moral ethical convictions An Immunization Exemption Form must be completed and on file at school If your child is exempt from immunizations he or she may be removed from school during an outbreak Does your child take any medication Please Circle No Yes Medication s Is your child on any special treatments nebulizer Epi pen catheterization etc Please Circle No Yes Treatment s Will your child need medication or treatment during the school day Please Circle No Yes Medication s Treatment s All Medications and Treatments administered at school require a completed Authorization For Medication During School Hours form
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