• Nurse’s Office at the
    Newcomb Middle School

    Jennifer Caruso, RN
    FAX: 609-757-4779
            jcaruso@pemb.org Phone: (609)893-8141, ext. 1152


    Please click on any of the underlined words to view/print the form that is mentioned.

    (To access forms you will need Adobe Reader).

    At least once a year, your child is called to the health office for vision, hearing, scoliosis and height and weight screening. Then there are other visits for illness, injuries, fights, shop and playground accidents, personal problems, “Monday morningitis”, daily medications and many other reasons. Many visits can be considered routine and are handled easily. Other visits often require a great deal of consideration and care because of the increasing number of students who are medically challenged with diabetes, spina bifida, asthma, life threatening allergies and other serious conditions. Our offices are very busy and at times seem like “mini emergency rooms”. Taking care of ill and injured students and giving daily medications is our main priority during the day. If we do not answer our phone, please leave a message and we will get back to you as soon as possible.

    Often your help as parents/guardians is needed in caring for your child. Please complete/review the Emergency Information Verification Form that your child will bring home to you at the beginning of the school year. It is important to make sure the phone numbers are correct and you provide emergency phone numbers of people we can call if you are not available. Please notify us if any of the contact phone numbers are changed, so we can update our records. If you would like your child to be able to take generic Tylenol/ibuprofen at school, make sure to check “yes”, sign and date the form and return it to school. We are not allowed to take permission from you over the phone, it must be in writing for legal reasons.

    Any medication that your child may need while in school, must be in the original pharmacy vial and accompanied by the Request for Medication Administration Form and/or a doctor’s note. Over-the-counter medications must be in the original unopened bottle and accompanied by the above listed paperwork. Please review our District Medication Policy. For everyone’s protection it is best if the parent/guardian brings the medication and paperwork directly to our office.

    Due to limited resources and very limited space, it’s important for you to keep your sick child at home. We’ll work with you by keeping your healthy child in school and calling you only when we feel it is necessary for you to know of an injury or for your child to be sent home. Please review the Student Handbook – Health Section and it should be able to answer any questions you may have concerning medical issues at school.

    Students who participate in our intramural or interscholastic after school sports program need to have a physical completed by their own doctor. Please review the Pemberton Township Local Health Resourcesif you need help with getting a physical. Physical forms are available from the nurse’s office and can be downloaded from the attachments listed on this page. During the summer month’s form are available in the main office.

    The NJ state Pre-Participation Physical Evaluation Form (4 pages) is the only form that we are allowed to accept by law. Please complete the History Form/Supplemental History Form and take it with you to the Dr.’s office. Your physician must review the History Form/Supplemental History Form and then fill out Physical Examination Form/Clearance Form.Incomplete forms will be returned and the student will be ineligible to participate in a sport until it is correctedThe Physical Examination Form/Clearance Form is good for 365 days or for one calendar year. One calendar year is from date of physical until exact date the following year. (example- 3/21/12 to 3/21/13)  If your child's physical should happen to expire in the middle of the sport season, they will be allowed to finish/complete that sport.

    NJ law mandates that the school doctor must check all sports physicals and sign the physical form prior to any student participation in after school sports. No student will be allowed to participate in any after school sports (including tryouts and practice) until the school physician has signed the student’s physical exam form. It is imperative that all paperwork is completed and returned in a timely manner to ensure approval and eligibility for sports participation. The school physician will be available to sign physicals on his scheduled day once a week. If your physical form is late, he will only sign these forms on his regularly scheduled day at the school.

    A Health History Update Questionnaire for Athletics must be completed every 90 days or prior to a new seasonal sport (fall, winter, spring) per state law. The update informs us if your child has had any medical problems since his or her last physical. Explain all “yes” answers on parent form.

    Students with asthma, serious allergic reactions or diabetes are required by state law to have action plans completed every school year. If these forms are not returned, your child will not be able to participate in any after school activities (sports, clubs and field trips).

    All physicals and medical forms must be turned into the nurse’s office. This cuts down on lost paperwork. We advise that you make copies for your records of any paperwork you send to the school. The Pre-Participation Physical Evaluation Form is very helpful and should be reviewed in its entirety.

    Asthma Forms – If your child has any type of asthma you will need to fill out the below listed forms and return them to the school nurse at the start of each school year. Your doctor will need to fill out the entire form, sign, date and stamp it with his office’s information. You the parent/guardian will need to sign the bottom of the asthma treatment plan and complete the Indemnification agreement for your child to be able to self-administer his/her medication at school. Please note that students staying after school must be able to self-medicate because no nurses are contracted to stay for after school sports.

    Asthma Treatment Plan with Parent Instructions/Authorization – 2 pages 

    Allergy Forms –
     If your child has any type of allergy (food, latex, bee, etc.) you will need to fill out the allergy forms and return them to the school nurse at the start of each school year. Your doctor will need to fill out the entire form, sign, date and stamp it with his office’s information. You the parent/guardian will need to sign parts of the forms as well. Please note that students staying after school must be able to self-medicate because no nurses are contracted to stay for after school sports. If you would like a delegate to assist your child in an emergency, please sign the delegate permission form. It is important for you to let us know if your child will be staying after school, so the appropriate staff member can be trained.

    Food Allergy Questionnaire
    Epi-pen packet - 3 pages new 5-2013.pdf

    Diabetes Forms - 
    Please contact the appropriate nurse concerning any diabetic forms. Most doctors’ offices will only use their forms concerning diabetic students. We will accept your doctor’s forms as long as no important information is missing per state law. If any needed information is missing, we will give you that section for your doctor to complete.

    Important 6th Grade Immunization Requirements (per the state of New Jersey)    

    • Tdap and Meningococcal vaccines are required for all entering 6th graders who are 11 years of age or older; 6th graders < 11 years must receive Tdap and meningococcal vaccines once age 11 is reached.
    • Students who do not meet these requirements will be excluded from school

    If you do not have health insurance or your health insurance does not cover immunizations, you may contact the Burlington County Health Department at 609-265-5526 to arrange for low cost immunizations. Southern Jersey Family Medical Center can also provide immunizations on a sliding scale fee and can be reached at 609-894-1100.

    Pemberton Local Health Resources 

    Local Health Resources

    Please call or E-mail our offices with any questions or concerns you may have about any of the above information.