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Catholic Academy of Sussex County

Please see below the following two forms:

Immunization & Medical Entrance Requirements

Pre-K Requirements

Minimum Immunization:

  1. DPT-4 doses of DPT. If DPT was given, a medical contraindication letter must be written by your physician on his stationary. This letter will be kept in the student's permanent health records.
  2. Polio – a minimum of 3 doses.
  3. Measles, Mumps, Rubella or MMR – 1 dose of MMR or of each component on or after the 1st birthday.
  4. HIB – 1 dose on or after the 1st birthday.
  5. Varicella (chickenpox) – 1 dose on or after the 1st birthday or a statement of previous varicella disease.
  6. Pneumococcal Conjugate Vaccine (PCV) – 1 does on or after the 1st birthday.
  7. Influenza Vaccine – 1 dose between September 1, 2012 and December 31, 2012.
  8. Proof of Immunization – a copy of your child's immunization records from your physician or local health department.

Kindergarten Requirements

Minimum Immunization:

In addition to the above,

  1. An additional dose of DPT given on or after the 4th birthday for a combination of 5 doses.
  2. An additional dose of Polio given on or after the 4th birthday for a combination of 4 doses.
  3. An additional dose of MMR given on or after the 4th birthday for a combination of 2 doses.
  4. Hepatitis B – 3 doses.
  5. Tuberculin Test – a current TB test is not required, please consult your physician.

Physical Examination

Pre-K and K: A report or letter of physical examination from your physician or health care provider.

Students are not permitted to attend school until all the requirements are met.Immunization & Medical Entrance Requirements.

Physical Forms:

Allergy Action Plan

Asthma Action Plan

Consent and Authorization for Administration of Medication

Authorization for Administration of Emergency Medication

Request for Medication to be Administered by School Nurse

Authorization of Release of Information

Physical Pre-K-4

Health History

Requirements for Volunteers/Chaperones:

In order to become a volunteer or chaperone at Reverend Brown School a three-step process is required by the Diocese of Paterson. The individual must:

1. Please read the attached Code of Pastoral Conduct, complete and return page 12.

2. Complete the Sterling background check form and submit it to the main office.

3. Attend a Virtus (Protecting God’s Children) Course.

Once steps one and two are complete, the person has 90 days in which to complete the Virtus training. A list of available classes and registration can be found at The volunteer must submit the certificate of completion to the Main Office.
The forms for steps one and two are available on the website and at the Main Office.