Communicable Disease | Illness | Injury Notifications | Consents | Non-Patient Specific Orders (Includes COVID-19 Samples)

Communicable Disease | COVID-19

The sample communications below should be reviewed and approved by your school medical director and school administrator. It is essential to maintain the confidentiality of affected students when sending notifications. If the local health department, in collaboration with the NYS Department of Health (NYSDOH), determines that there is an outbreak of a reportable communicable disease, they will provide response guidance to schools' medical directors and BOE's.

Communicable disease prevention, surveillance, notification, and reporting are important roles provided by the school health team. In addition to documenting the care of ill or injured students according to district procedures, it is important to share your observations and recommendations for following up with the student's parent or guardian. Information may include:

  1. A description of the illness which includes the date, time, and details of the complaint.
  2. Recommendations for follow up.
  3. School health services contact information.

General Information on Illness and School Attendance

When to Keep Child home Instructions to Parents/Guardians - Sample letter to share district guidelines. This letter should be reviewed and approved by the School Medical Director prior to use. (NYSCSH 12/2019) 

Sample Notification of Student Health Office Visit Due to Symptoms of COVID-19

Your Child Was Seen in the Health Office Due to Symptoms of COVID-19 - This letter provides parents with information on why their child was excluded and why they are required to see a Health Care Provider (HCP), along with information to share with the HCP on what is required for students to return to in-person learning. This letter should be reviewed and approved by the School Medical Director prior to use. (NYSCSH 12/3/20)

Sample Non-Patient Specific Order for BinaxNow™ COVID-19 Testing

Sample School COVID-19 Testing Consent Form and Instructions

Sample School COVID Testing Consent Form- This sample consent form was created to assist schools with the requirement to have parent/guardian permission on file prior to testing a child, this form also informs the parent/guardian of their child’s test results and other information which may be disclosed as permitted by law. (NYSCSH 12/3/20)

Sample School COVID Testing Consent Form Instructions- This instruction sheet was created to assist schools in using the Sample COVID Testing Consent Form as a PDF. (NYSCSH 12/3/20)

Sample Health Office Visit for Illness|Injury Notifications and NYSDOH Information Fact Sheets

Sample Illness Notification-This letter may be customized to alert parents/guardians to communicable illnesses. (NYSCSH12/1/19). 

NYSDOH and CDC Information Fact Sheets (this list is not all-inclusive)


The following sample form may be customized and used by districts based on your school  Medical Director's Guidance and BOE policies.  

Notification to Parent/Guardian of Student Health Office Visit

Provides a checklist that may be used by the school nurse to document student visits, first aid provided, and the method by which the parent/guardian was notified. It includes information on injuries related to abrasions, cuts, or puncture wounds, which may require follow-up.  Symptoms of potential infection and recommendations for monitoring are provided. Your school medical director should approve this form.

Additional Resources on these topics are available in the A-Z Resources
Page updated 4/22/2021