Communicable Disease | Illness | Injury


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:

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

Sample forms may be customized for use by districts consistent with NYSED, local district and Medical Director's policies and guidance,

General Illness Notifications and Follow-Up

Sample Student Daily Visit Form- Aids school health personnel in tracking follow-up on student visits to the health office. It is available in landscape and portrait and is customizable. (1/2018)

Notification of Student Illness Form - Fillable form to communicate student's visit to the health office due to illness

Notification to Parent/Guardian of Student Illness - Customizable MS Word Document

Classmate Illness Alert

When to Keep Child home Instructions to Parents/Guardians- Provides a customizable sample letter to share district guidelines. (9/2017) 

Specific Illness Letters

Chicken Pox - Letter to Parents/Guardians

Conjunctivitis - Letter to Parents/Guardians (Updated 2019)

Fifth Disease - Letter to Parents/Guardians

GI Illness - Letter to Parents/Guardians

Hand Foot Mouth Disease (Coxsackie Virus) - Letter to Parents/Guardians

Head Injury - Letter to Parents/Guardians 

Head Lice- Letter to Parents/Guardians

Impetigo - Letter to Parents/Guardians

Measles notification is determined and created in consultation with the NYS or local health department.

Pinworm Infection - Letter to Parents/Guardians

Pneumonia - Letter to Parents/Guardians

Ringworm - Letter to Parents/Guardians

Scabies - Letter to Parents/Guardians

Shingles - Letter to Parents/Guardians

Strep Throat - Letter to parents/guardians


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

Notifications of Injury: Abrasions, Cuts, or Puncture Wounds  This form may be used to notify parents and guardians of injuries related to abrasions, cuts, or puncture wounds, which may require follow-up.  Symptoms of potential infection and recommendations for monitoring are provided.   

Notification to Parent/Guardian of Student Injury - Customizable MS Word Document.  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.  Your school medical director should approve this form.

Additional Resources on these topics are available in the A-Z Resources

Updated 10/21/19