https://hipaa.jotform.com/Coplin_Health_Systems/SchoolTelehealthRegistration
Be kind, for everyone you meet is fighting a battle.
Plato
Coplin Health Systems
School-based Health Enrollment Form
Now partnering with Van Devender Middle School to provide medical care from the convenience of the school. Your student will be seen during the school day via tele-health.
Scan the QR Code to be directed to the form.
If your student requires medicine (prescribed or over-the-counter) during school hours or they require special diet--you must have their prescribing doctor complete the necessary form(s) below.
MOVHD VMS Mobile Dental Clinic
The Mid-Ohio Valley Health Department Mobile Dental Clinic will be at Van Devender Middle School yearly. Students who DO NOT HAVE A DENTIST OR HAVE NOT BEEN TO THE DENTIST IN A YEAR OR MORE may participate. Please contact the school nurse to request a consent form to be sent home with your child. You may also download and print a consent form and return using the 'Upload Consent Form' button. A dental hygienist will perform a screening, cleaning, fluoride, and sealants if applicable. Please take advantage of this great opportunity for your child to get their teeth cleaned! Only students with completed consents will be seen. If your student is in 6th grade, this cleaning will count towards 7th grade entry. Thank you!
Print, sign, and send the dental form electronically
1) Click the image below to download and print.
2) Complete and sign the form.
3) Use your phone to snap a picture of each of the two pages of the consent form.
4) Use the button below to upload consent form. Note: Be sure to select both images when sending.
Upcoming!
Immunization & Exam Requirements for All WV 7th Graders
Attention Parents / Guardians of Students Entering 7th Grade:
7th grade is a school checkpoint grade. All West Virginia students entering 7th grade must have one dose of the Tdap (Tetanus, Diphtheria, and Pertussis) and one dose of the Meningococcal (MCV4) vaccine. Please call your primary care physician to schedule a vaccine review and immunizations for your adolescent. Students must also have a record of a Dental and Physical Exam before entering 7th grade. Students will be excluded from school by state law if not received.
Meningitis - poses a serious threat to adolescents. Meningitis can kill a healthy person in 48 hours or less. Up to 1 in 5 survivors of Meningitis have problems for the rest of their lives, due to the loss of limbs, scarring, hearing loss and neurological damage.
Tetanus, Diphtheria, and Pertussis (Whooping Cough) - Pertussis is spread by coughing and sneezing. Anyone can catch Pertussis and spread it to others, including infants.
To assist with meeting immunization requirements, the health department will visit schools throughout the year to hold a vaccine clinic. Please contact the school nurse for a consent to be sent home with your child. Again, this is a benefit to you and your student. Just a reminder - there are no exclusions or waivers for this. If not met, your student will not be able to start school in the fall and will be sent home on the first day of school.
PLEASE BRING THE COPIES OF THE UPDATED IMMUNIZATION RECORD, DENTAL RECORD, AND PHYSICAL EXAM RECORD BY THE FIRST DAY OF SCHOOL TO THE SCHOOL NURSE.
Information & Forms
Find all forms at the top-right of the page under "All Medical Forms."
Return the following forms to the school nurse:
MOVHD Screen Checklist
MOVHD Vaccine Consent (only need to upload the 1st page please)
Your child may return these forms directly or you may upload them electronically:
VMS Nurse Page QR Code
Nurse Contact Info QR Code
