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Back-to-School Packet 2021-22

Dear Parents and Guardians,

In preparation for the upcoming 2021-22 school year at York Catholic Middle & High School, please complete the following information by August 4.

Please note:

"Participant" refers to the Student.

All areas noted with a red asterisk (*) are required fields for completion.


Please complete the following information to assist our school nurse in providing health care for your child while at school.

Please note:  Due to unknown side effects or reactions, school personnel are prohibited from giving the first dose of any non-prescription medication to a student.

The following requires permission from a prescribing physician:

  • Usage of an inhaler or Epi-pen
  • Usage of prescription medication

Please print the appropriate form located in the Links section to the right to have the doctor sign and return the form to the school nurse.

Medical Information - July 01, 2021 to June 30, 2022
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