MPHS has a full-time nurse, Rebecca T. Hartline, RN. She can be reached by calling the school at 980-343-5800 or
via email at firstname.lastname@example.org
• If your child should need medication while at school, a medication authorization form needs to be completed
by you and your doctor. This includes prescriptions, over the counter medications and other items such as
cough drops, lotions, and even Chapstick. Links to these forms are listed below. Please note there is a
generic form as well as forms specific to chronic illnesses.
• If your child needs a medication during the day and you would like to deliver it to the school, you must be the
one to administer the medication. Please ask the front office staff to call your child from class. The
medication may not be left at the desk for your student to pick up or left with the nurse per
CMS/Mecklenburg County Policy; (unless you have a written and signed doctor’s order.)
Requirements for students new to CMS
• Each child new to CMS will need a Health Assessment (physical) dated within the 12 months prior to the first
day of school. A copy of your child's up to date immunization record is also required. (Copies of
immunizations printed by former schools will not be accepted. They must be documents from a medical
provider, etc., or copies of those will suffice.) These forms need to be submitted within 30 calendar days of
the start of school. Feel free to send forms in as they are completed or over the summer. The required
Physical Assessment form link is below. Please note this is the only accepted Health Assessment form.
Immunization guidelines are also linked below.
Thank you for working with us to make sure your child is safe while at school.
Here are some helpful links:
• Medication Authorization
• Asthma Action Plan
• Diabetes Care Plan
• Severe Allergy Care Plan
• Seizure Care Plan
• Diastat Order Form
• Sickle Cell Care Plan
• Diet Order Form
• Health Assessment Form
• Immunization Requirements