Magnus Health Requirements

Thank you for beginning your Lumberjack’s requirements in Magnus.  Because they are your student's medical records, every requirement must be updated yearly to remain current.  There are 20 requirements (not every student needs all 20 completed, but you do need to open all 20). All but 8 of those you can complete and sign online.

Start by looking through each requirement and the instructions included here so you know what is needed and expected- several require that they are completed and signed by a health care provider (HCP).  Be sure you plan for this- often waiting to make an appointment or get a document done at the last minute will delay the requirement being completed and may delay your student's arrival on campus.

Putting off completing requirements may mean you are scrambling in August to complete them- please remember there are no exceptions or extensions to the requirements being done prior to your student arriving on campus.  It is important to have complete medical records and consent in place to care for your student.

Please double-check the due dates on all requirements- there are no exceptions to these.  No student may be on campus unless ALL requirements are complete and approved by the health center.

For the 8 requirements that must be printed and completed offline or uploaded, please do not send, fax, or bring completed forms to Hebron Academy or the Hebron Academy Health Center.  We cannot upload them for you.  Either upload the completed requirement as a PDF (NOT a photo please*) to the requirement or use the FAX sheet provided for you in each requirement and FAX the finished requirement to Magnus.

Double-check all requirements before you submit them- that will save you having to redo any that are not complete or not done correctly.  Please remember these are legal documents, which is why we ask they be filled out completely and correctly.

Please read the Community Handbook carefully, especially the part related to the health center.

Please direct all questions to healthcenter@hebronacademy.org.  Please title your email Magnus Requirement and please include your student’s full name in the email.

*We ask that you NOT make photos of documents to upload- they do not come through clearly, they often are not readable at all and many outside providers will not accept them.  Please only upload PDFs, not photos.

Vital Health Record

• Due date is June 15

• Must be completed online

• You may go back and update the information at any time over the school year-please notify the health center at healthcenter@hebronacademy.org if you do update

• This record helps the healthcare team provide care for you student- please complete it as thoroughly as possible

• For day students- if  your student takes a daily prescription medication, please include that

Medical Consent

• Due date is July 1

• Signed online

• This form gives your consent for treatment by the health center staff and physicians, counseling center and athletic trainer as well as when your student needs to be seen by an outside provider

• Please have a parent or legal guardian sign even if your student is 18 years old or older

HIPAA Patient Privacy for Bedard Pharmacy

• Due date is July 1

• This is a document that outlines your HIPAA rights for our school pharmacy, Bedard’s Pharmacy

• Signed online

Release of Information

• Due date is July 1

• E signed

• Two separate releases

  • One is to allow Hebron Academy to request information from an outside provider

  • One is to allow Hebron Academy to share information with an outside provider

• Neither release form would be used without your notification first- this just means they are in place if needed to save a step

International Student Injury and Sickness Plan

• Due date is July 1

• This document is completed online

• This form is for all international students- if your student is a domestic student, simply go in and answer the requirement NO

• All international students must carry the school-sponsored insurance - there are no exceptions

Proof of Insurance for Domestic Students

• Due  date is July 1

• If you are a domestic student, please make a PDF of BOTH sides of your insurance card and upload it to the requirement

• If you are an international student there is no need to upload a card- once we have your information for your international student insurance, we will upload it for you.

• If your student is insured under a state-sponsored insurance (such as Medicaid or a local provider only insurance plan) or would like to explore additional domestic insurance for your student, please contact the health center at healthcenter@hebronacademy.org

Over the Counter Medication Permission

• Due date is July 1

• This document gives the health center, athletic trainer, and trained faculty consent to give over-the-counter medications (OTC) listed in our formulary.

• The document is completed and signed online

• You may choose which OTC is given to your student- please be aware that limiting options may limit the treatment we can give.

• Students MAY NOT have any type of medications in their room- there is no exception to this.  Please read the section of the Community Handbook

Consent for Supplements

• Due date of July 1

• Any student who may need or want a supplement must have the form filled out for each supplement

• Does not require a health care provider's signature unless ordered by one.  If ordered by a HCP, have them fill out the prescription form instead

• A supplement is any vitamin, mineral, or work out supplement

• All supplements must be approved and labeled before being allowed in a student room

• Please read the Community Handbook guidelines on what supplements are allowed and the process for approval

• Any naturopathic medication (such as melatonin) requires a prescription form with a HCP signature

COVID-19 Vaccine Card or Document

• Due date is July 1

• Please upload a PDF of your student’s completed vaccine card or document that includes all required boosters

• All vaccines and boosters must be FDA or WHO-approved

• A student must be fully vaccinated and boosted prior to arrival on campus

Consent for COVID-19 Vaccination

• Due day is July 1

• This is completed and signed online

• This enables the health center to vaccinate your student in the event a booster is recommended or required.

• Hebron Academy follows all CDC guidelines as well as recommendations from the FDA and our consultants.

• The vaccine may be given on campus or at an outside provider or clinic

• You will always be notified before any vaccine is given

COVID-19 Testing Consent

• Due date is July 1

• The document is signed online

• This document gives permission for the health center to test for COVID-19, following CDC, Maine DOE, and our consultant guidelines.

Influenza Vaccine Permission

• Due date is July 1

• This consent form allows Hebron Academy to vaccinate your student against influenza (flu) during the late fall semester

• Permission and signature for this document is online

• Because of the congregate living conditions, we highly recommend you consent to allow the yearly flu vaccine be given to your student

ImPact Permission Form

• Due date is July 1

• The document is signed online

• This document gives Hebron Academy permission to perform the ImPact Test with your student, which is required for all students their first year at Hebron Academy and then every other year after that.

• Information on ImPact testing can be found at https://www.cdc.gov/headsup/basics/baseline_testing.html

Social/Emotional Health

• Due date is July 1

• There are 2 ways to complete this form.  You can print, complete the form,  and upload or fax the completed form to the requirement or there is a link provided in the requirement to fill the form out online.  Once completed, you download the form to your hard drive, then upload it into the requirement to complete the requirement.

Annual Medical Evaluation Form

• Due date is August 1

• Every student must have an annual evaluation by a healthcare provider (HCP) within 12 months

• This form needs to be printed out, completed by both a parent and a primary HCP and signed and dated by the HCP, then uploaded when complete

• We only accept this form

• Part 1 needs to be completed by a parent or guardian and taken with Part 2 for the annual evaluation.  The requirement is not complete without Part 1 completed and included.

• Part 2 must be completed, dated, and signed by the student’s primary HCP.  Please make sure the HCP completes EVERY part

• We understand you may have limitations placed by your insurance on how frequently your student may have their annual evaluation.  Please contact us at healthcenter@hebonacademy.org with any questions on how to complete this form

• Please note we do not allow immediate family members who are health care providers to complete this form

Immunization Form

• Due date August 1

• This document must be printed out, filled in by your student’s primary HCP, signed and dated by the HCP, and uploaded to the requirement

• We do not accept other immunization documents- please only use the one provided

• Please check this requirement each year for any vaccines that need to be updated

• Please check the Community Handbook for the vaccines required of every student attending Hebron Academy- we recommend you check early in the summer to ensure you have time to update the vaccines needed by your child

Prescription Medication Form

• Due date is August 1

• If your student requires any daily medication prescribed or recommended by a HCP, you need to have this form completed in order for the student to have it administered at school

• If your student does not take daily medications prescribed by a HCP, simply mark not applicable in the requirement

• Please print out and have the prescribing healthcare provider (HCP) complete, sign and date this form for EACH medication.

• Anytime a medication dosage is changed, or a new medication is prescribed, a new form must be filled out

• Students may not at any time have prescription medication in their room, with the exception of emergency medications, inhalers and approved OCP and topical prescriptions.  Please read the section of the Community Handbook on this.

• Prescription medications must be filled by our school pharmacy, Bedards, and may only be prescribed by a HCP licensed in the US.  Please read the Community Handbook outlining these guidelines.

• We cannot accept prescriptions hand-delivered or mailed.  Students may not be treated or prescribed for by a family member.

Asthma Action Plan

• Due date August 1

• If your student has not be diagnosed with asthma or no longer needs treatment, simply go into requirement and answer NO

• If you student is being treated for Asthma and carries an inhaler, please print out the document and have it completed, signed and dated by the HCP who treats them for their asthma

• If your student carries an inhaler, a Prescription Form must also be completed for the inhaler

Allergy & Anaphylactic  Reaction Plan

• Due date August 1

• If your student does not have an allergy that is moderate to severe and requires immediate response other than an OTC, simply go in and answer NO.  This form is not for seasonal allergies or simple reactions.  Please note those in the Vital Health Record

• If your student has an allergy to a medication, food, or substance that causes a moderate to severe reaction and requires immediate treatment, please print off and have this form completed by the HCP who treats your student for their allergy.  Once completed please upload the document to the requirement

• If your student requires an emergency medication (such as an Eipen or Auvi-Q), a prescription form must be completed by their HCP as well.