Campus Life
Campus Services

Health & Wellness

Health Forms & Information

As you prepare for the 2017–18 school year, please refer to this information, as well as the forms to the right.

Our requirements are consistent with both Maryland State law and our commitment to encouraging good health and well-being for our students. As your son’s information will be submitted in various forms, we thank you in advance for your patience and close attention to detail. Please note that health information documents requiring the signature of a physician must be submitted on paper. All students are required to provide health forms by September 5th the first day of classes. Students trying out for fall sports must submit forms prior to or on the first day of practice.

R
equired Health Information & Forms:
 
Paper Forms:
Physical
Physicals for the 2017 – 2018 school year are to be completed between May 1st and September 5th.  This document gives the school a summary of your son’s present physical well-being. This physical form is REQUIRED for all students regardless if they are participating in Athletics. A copy is enclosed; it is also available online. Students trying out for fall sports must submit health requirements prior to or at the first day of practice. If you need a provider to perform a physical for a low cost, you may use this link Providers for Sports Physicals
 
Immunization
All students must submit a copy of their immunization record. If there are new immunizations or boosters, a new form should be sent to Loyola.
 
Online Form: (please note you must be logged into Loyola Blakefield’s website with your parent credentials to see this form)
Medical Information Form
Introduced last year and available after July 18th, this form is specific information associated with your son’s medical history, conditions, allergies as well as primary care and insurance information. Only one parent needs to complete and submit the form. This form must be completed by September 5th.
 
 
Other Forms (if applicable):
 
Over-the-Counter Medication Consent (not required, but recommended)
This year there will be a form available on-line after July 18th giving permission for the School Nurse to administer over the counter medications. This form may be completed at any time during the school year. It is strongly recommended if your son takes any over the counter medications you complete the form before the first day of classes.
(please note you must be logged into Loyola Blakefield’s website with your parent credentials to see this form)
 
Prescription Medication Consent
This form permits the School Nurse to administer prescription medications that your son takes during the course of a school day. One form for each prescription must be provided and signed by a doctor. All students who carry epi-pens and inhalers are required to have this forms filled out and signed by the physician.  It is strongly suggested that back up epi-pens and inhalers are kept in the Health Room as well.
 
Health Action Plans
If your son has a condition such as severe allergies, asthmas, diabetes or seizures, please submit a Health Action Plan form. This document provides specific information to help facilitate the appropriate actions in the event that your son requires treatment while at school.
 
 
It is strongly advised you make copies of all forms for your records before they are submitted to the school.

Forms may be dropped off over the summer to the Health Form Drop Box located in the Dean of Students’ Office in Knott Hall. Please do not hand-deliver forms to anyone.

Forms also may be mailed to:
Loyola Blakefield
c/o Mrs. Kelly Klug, BSN, RN 
P.O. Box 6819
Baltimore, MD 21285-6819
 
500 Chestnut Ave. Towson, MD 21204
Ph: 410-823-0601