The health concerns of today’s school age children involve a broad range of physical, social, behavioral, and emotional issues which may impact a student’s educational progress. It is our goal to help identify these issues and to provide comprehensive health services to the student population. In doing this, we firmly believe that Orange Elementary Schools are promoting better school participation, improved learning and higher educational achievement for all students.

“You cannot educate an unhealthy child, and you cannot keep an uneducated child healthy.” – Dr. M. Jocelyn Elder, Former Surgeon General

Because of the physical limitations and ages of some of our children, increased susceptibility to infection is a very real concern. We work in such close contact and share common work and play equipment, so spread of infection or illness from one individual to another is common. Although we do make a sincere effort to regularly disinfect commonly used objects; the best protection from illness is to keep your child home when symptoms of illness are present. Here are some guidelines to follow: 

Keep your child home if they:

• have evidence of a newly developed cold (runny, stuffy nose, coughing, sneezing). The greatest period of contagion is the first 2-3 days after      onset of symptoms. 
• have the flu or flu symptoms. 
• have an elevated temperature of 99.6˚ or above (oral temperature). 
• have a suspicious rash. 
• have a weeping sore or discharging eye(s) or ear(s). 
• have had an upset stomach, vomiting or diarrhea within the past 24 hours. 
• have a contagious illness (strep throat, tonsillitis, bronchitis, conjunctivitis, etc.)   
 until he/she has been on medication at least 24 hours from the first dose. 

If your child should develop any of these or other symptoms hindering the child’s availability to learn during school hours, the school nurse will notify you and the child will be dismissed. Please keep your emergency contacts updated as they will be notified for a dismissal if you are not available. The child is expected to be picked up in a timely manner to reduce the spread of illness to other students and/or staff. 

Please keep the health office apprised of any serious injuries or illnesses.


Each year the student’s health records are audited to make sure that physical examinations and immunizations meet the requirements specified by the Massachusetts Department of Public Health. If your child is found to be missing appropriate documentation of a required immunization or physical examination, you will be notified and asked to contact your child’s primary care physician in order to update or clarify their history. It is very important to respond in a timely manner, in order to insure that your child’s school health record is considered to be in complete compliance with state requirements.


  • The Orange Elementary School Health Services encourage that medication be administered before and after school if possible.

  • When medication needs to be given during school hours, there must be an order from a health care provider and a parental permission form with the medication. 

  • Medication must be delivered to the school in a pharmacy or manufacturer labeled container by the parent, guardian or responsible adult. (Medications are not accepted in such things as plastic bags.) No child is permitted to bring medication to school. 

  • Students are not permitted to carry their own medications. 

  • On school half days, medications scheduled during lunch time will not be given.



Screenings Provided in the Elementary School:

  • Vision: Grades K, 1, 2, 3, 4, 5

  • Hearing: Grades K, 1, 2, 3

  • Height, Weight and BMI measurements: Grades 1, 4

  • Postural: Grades 5, 6

Physical Examinations
The Massachusetts Department of Public Health regulation states that every student is required to periodically provide a written copy of a physical exam to the school nurse. During elementary school, there are two times when parents are required to provide the school with a completed physical exam form from a doctor. The first is at the time of entrance into school (Kindergarten), and the second physical form is due in 4th grade. 

Our best advice for parents is that they request a copy of the physical form and an update on immunizations each time the child visits his or her pediatrician.  Parent should bring each completed medical/immunization form to the school; ask for a copy, then leave the form with the school nurse so that the child’s medical records stays up to date. Parents should keep their copy of each of these physical forms for their own records.

Physical Exams are required upon entrance of school (Kindergarten) and Grade 4.  It is recommended that your primary care provider perform the physical exam since they have a comprehensive knowledge of your child’s health status. 

Parents should notify the school nurse at the beginning of each school year if they do not want their child to participate in any of the identified health related screenings. 

The screenings done at school are simple screenings and are not meant to replace routine or diagnostic procedures and testing done by your family physicians. 

Hearing and Vision Screening 
In April 2009, the Massachusetts Department of Public Health amended their regulations on Physical Examination of School Children, 105 CMR 200.00, to improve the screening and monitoring of the health assessment of children across the Commonwealth. The hearing and vision screening guidelines were modified as listed below:

     Hearing Screening – Students in grades K-3, 8 and 10 annually
     Vision Screening – Students in grades K-5, 8 and 10 annually

Parents will be notified of any problems that necessitate a medical follow-up. If at any time there is a concern about your child’s hearing or vision, please contact the school nurse to schedule a screening. 

Body Mass Index Program
In accordance with the Mass Dept of Public Health (MDPH), schools are required to perform height, weight and body mass index (BMI) screenings for students in grades 1, 4, 7 & 10. The purpose of the screening program is to give parents additional information about their child’s weight status and ideas for living a healthy life.

BMI is a measurement that is used to show a person’s “weight for height for age.”  It is calculated using a formula that includes an individual’s height and weight.  Just like a blood pressure reading or an eye screening test, a BMI can be a useful tool in identifying possible health risks. 

BMI does not tell the whole story about a child’s health status.  BMI does not distinguish between fat and muscle.  For example, if a child is very athletic and has a lot of muscle, his or her BMI may be high even though he or she is not overweight.  That is why parents are encouraged to share the results with their child’s health care provider and have them explain the results of their child’s BMI screening.  They are in the best position to evaluate a child’s overall health. Please contact the school nurse for the results of the BMI screening and please visit the Massachusetts DPH website at for Frequently Asked Questions about BMI and Mass in Motion. 

Parents and guardians may waive BMI screening by submitting a written request to the school nurse.

Postural Screening
The state of Massachusetts mandates that all students in grades 5 through 9 be screened for scoliosis. Your child’ posture will be screened in grades 5 and 6.  Parents will be notified of any screening results that necessitate a physician referral.
If you do not want your child to participate in the postural screening program please send a doctor's note showing that he/she was screened for scoliosis by the doctor prior to the screening day.  The note should go to the nurse.

P.O. Box 680
507 South Main Street,
Orange, MA 01364
(978) 544-6763


3 Dexter Street Extension
Orange, Massachusetts 01364
(978) 544-6080



 59 Dexter Street
Orange, Massachusetts 01364
(978) 544-0018