Phone Number

• 703-937-1610

Hours

• 8:15 a.m. - 3:45 p.m.

Staff

• Ashley Haas | School Health Aide | 703-937-1610
• Pamela Manuyag | Public Health Nurse | 571-595-6726

Student Health at Mosaic

Health Information Form

The Health Information Form is to be completed by the parent or guardian at the start of each school year. The completed form is to be returned to the school clinic.

Prescription Medications

Children who need to take medication during school hours must have a signed Medication Authorization, Release, and Indemnification Form. Prescription medications require the signature of both the parent/guardian and the healthcare provider. Inhalers and EpiPens® require authorization forms.

• Medication Authorization Form

• Epinephrine (EpiPen) Authorization Form 

• Inhaler Authorization Form

Over-the-counter Medications

Over-the-counter (OTC) medications are drugs that can be purchased without a healthcare provider’s prescription and are used for the relief of symptoms on a temporary basis. With parent/guardian and healthcare provider authorization, OTC medications may be given on an "as needed" basis throughout the school year. Parents/guardians may authorize limited use for 10 consecutive days with a completed Medication Authorization Form (such as cough medicine for cold symptoms). OTC medications for pain relief ONLY for headaches, muscle aches, menstrual cramps or orthodontic pain may be given with parental/guardian permission and appropriate documentation. The medication must be supplied by the parent/guardian in its original container. Examples include Tylenol, Advil, Pamprin®.

Transport of Medications to and from School

Parents/guardians must transport medications to and from school. All medications must be kept in the clinic and taken under adult supervision. Only certain emergency medications, such as diabetes medications, Epipen® and inhalers may be carried by the student with the authorization of both their parent/guardian(s) and healthcare provider.

Scheduling Medical Appointments

Please make every effort to schedule appointments outside of school hours. When this is not possible, please send a note to the school on the morning of the appointment stating the time the child will be picked up. Children should bring appointment notes to the attendance secretary before homeroom. The student's name will then be shown on an early dismissal list. For safety reasons, parents/guardians must sign out children in the office.

Release of Student from School

Only those individuals designated on the Emergency Care Information form will be contacted either to excuse or take your student home. If the clinic contacts you to excuse your student from school, established release procedures as outlined in FCPS Regulation 2234, will require the emergency contact for elementary students to sign the school release log. In a health emergency, 911 will be called prior to contacting the parent.