North Shore Hebrew Academy High School Where Dreams Become Accomplishments

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Health Services Requirements

      Health Services:  (516) 487-2424   x1127
Click below for all Health Services Requirements



All 9th and 11th grade students, all Transfer Students and all student athletes are required to submit the following forms:

#100, #102A, #105, #109, #200, and Emergency Contact 




Links for all required Immunization, Medical & Sports forms are listed below for

                    convenient access and printing.





Please note:

1.  There is a new policy for the Meningococcal Vaccine.

        (Scroll down for ALL Immunization Requirements)



  • Please be advised, the NSHA HS does not grant religious exemptions.
  • If you choose to have your son / daughter attend the NSHA HS, and they have not been immunized, the immunization series for each required immunization for admission/ attendance in school,  must be started prior to the start of the school year.  
  • Your child will be "in process" for the continuation of the immunizations series. 
  • VERY IMPORTANT:  The ACIP Immunization Guidelines "catch up schedule" is to be followed with the proper age related dose/s, and proper intervals, between doses.
  • After each doctor's appointment, a medical note from the physician is required to be submitted, with the date of the next scheduled office visit for the continuation of the immunization series.  The physician's signature, date, and office stamp are required on all forms/ notes.
  • All students must be compliant , as per the New York State Department of Health, for admission/ attendance in school. 
  • Form # 200:  Record of Immunizations Form is to be completed, signed, dated, and stamped by the physician.



3. The Immunization Medical Exemption Statement Form must be

    completed, signed, dated by the physician with office stamp affixed.

    This form is required to be renewed annually.
GUIDELINES: FLU GUIDE & When Students Should STAY HOME Due to Illness (click below)

The REQUIRED Medical forms are listed below (click, open & print):
For medications to be administered during school hours only, the following forms are required:
#300, #302, Provider & Parent Permissions 
1 - Provider and Parent Permission is Required for Independent Medication Use and Carry (Inhaler, EPI-PEN, and Diabetic Management)
2 - Appropriate Action Plan - Asthma, Allergy, Diabetic Management Plan to be completed by the physician and parent.
As per NY State Regulations, mandated screenings of scoliosis, vision, and hearing will be done by the nurse at the appropriate time unless notation from the physician is on file. Parents/guardians will be notified in writing of any deficits or concerns that are noted during the screenings

Physical Education:
If your son/daughter should sustain an injury which requires him or her to be medically excused from physical education, a physician's note with a diagnosis and length of time student is to be excused is required. Physical Education is a requirement for high school graduation.

In addition, when your son/daughter may return to physical education, a medical clearance note from the physician is required. Students will not be permitted to resume Physical Education or sports without medical clearance. Students who are medically excused from physical education (gym) are not permitted to participate in the interscholastic athletics program. Students must be cleared for gym before they can participate on team sports.