Health Services


Forms Library

Too Sick?


We are excited to have your student join us at Provident Charter School and assist them to stay safe and healthy this school year.

Provident Charter School’s Health Office aims to encourage, support, and improve student health. We provide all state-mandated services in addition to health promotion education and disease management support.


    • To meet all state and federal guidelines regarding School Health
    • To promote, protect and improve the health and safety of all students through policies and best practices.
    • To build relationships with familial and community supports that improve health and academic success.
    • Provide a culture of health and wellness to allow students to reach physical and academic goals.

Required Forms

Below are the required forms for each grade level.  Locate your child(ren)’s grade level to see the required Health Services forms that must be submitted for your child(ren).

Tarjeta de Emergencia Estudiantil en español

2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade

Mandated School Health Requirements


The following are the minimum immunizations that are required for all students entering school for the first time.

      • 4 doses Tetanus, Diptheria, and acellular Pertussis (1 dose on or after the 4th birthday)
      • 4 doses Polio (1 dose on or after 4th birthday, and 6 months after the previous dose given)
      • 2 doses Measles
      • 2 doses Mumps
      • 2 doses Rubella
      • 3 doses Hepatitis B
      • 2 doses Varicella – **or a written statement from physician/designee indicating month and year of disease or serologic proof of immunity. In addition to the requirements listed above, students in grades 7-12 are required to have the immunizations listed below. Please note that 7th-grade students will not be permitted to start their 7th grade school year without completion of the Tdap and the 1st dose of MCV. 12th-grade students will not be permitted to start their 12th grade school year without completion of the 2nd dose of the MCV.
      • 1 dose Tetanus/diphtheria/pertussis (Tdap)
      • 2 doses of Meningitis vaccine (MCV)

**The Allegheny County Health Department offers free immunizations. Please call 412-578-8062 for information.


Medical exemption – when the physical condition of the child is such that immunization would endanger life or health (requires physician’s signature).

Religious exemption – when the parent/guardian adheres to a religious belief whose teachings are opposed to such immunizations (requires parent/guardian signature).


The school health law requires physical examinations for children entering school for the first time (Kindergarten or 1st grade) and in grades 6 and 11.
Physical Examination of School Age Student [PDF]


All students entering school for the first time (Kindergarten or 1st grade) and in grades 3 and 7 are required by the State of Pennsylvania to have a dental examination.

Dental Health Exam[PDF]

The state recommends these exams be done by your private physician/dentist since they can best evaluate your child. If you would like the school physician/dentist to do the required exams please let your school nurse know at the beginning of the school year.


Before any prescribed medication may be administered, PCS requires a Medication Administration Consent and Licensed Prescribers Medication Order Form. Medication orders do not carry over from school year to school year. Therefore, new physician orders and parent(s)/guardian(s) permission must be submitted each school year. Prescription medication shall be delivered in its original packaging and match the Medication Administration Consent and Licensed Prescribers Medication Order Form.

View our Student Handbook for additional information.

Too Sick for School?

Children of all ages work hard during the school day, and for an ill child, the energy required to complete the day is often not there.  Not only does this put your child at risk for prolonged illness, but it also puts the children around him/her at greater risk for becoming ill. As your school nurse, I am dedicated to the health and wellness of all students. Please see the following information to assist you in making an informed decision about your child.

These are some reasons when your child should be kept at home:

      • Fever – ( 100° F || 37.8°C ) – The child should remain at home until 24 hours fever-free without fever-reducing medications.
      • Nausea and Vomiting – Children should be free of vomiting for 24 hours before returning to school.
      • Diarrhea – Children should be free of diarrhea for 24 hours before returning to school.
      • Conjunctivitis (Pink Eye) – Children should be kept out of school until 24 hours after the start of the appropriate treatment or until the physician certifies the child as non-infectious.
      • Influenza (Flu) – Children should be fever-free for 24 hours without the aid of fever-reducing medication.  Please consider cough status as well.  Persistent cough interferes with your child’s ability to participate in the learning process. Cough should be under control before returning to school.
      • Strep Throat – Children should be kept out of school until 24 hours after the antibiotic is started.
      • Fifth’s Disease – Children should be kept out of school if fever is present.  Students can come to school with a rash.
      • Acute cold and/or persistent cough – It is difficult for your child to concentrate with a constant cough and or nasal congestion. Consider keeping the child at home until cough and or congestion is under control.
      • Inability to sleep most of the night – If a child is up all night because they do not feel well, sending them to school to “try and get through the day”; most likely won’t work as they won’t have the energy available necessary to finish the day.
      • Pediculosis (head lice) – Stay home until proper shampoo treatment. The school nurse must check your child before they can return to school.
      • Norovirus – Norovirus is a highly contagious virus. Norovirus infection causes gastroenteritis (inflammation of the stomach and intestines). This leads to diarrhea, vomiting, and stomach pain. Please see this site for more information on how long to keep your child home from school: