Health Room 

    General Information 

    Phone:  240-740-3242

    Annie Estrain(Montgomery County DHHS Health Tech)
    Kerry Holtz (Montgomery County DHHS Nurse)

    Important Forms  

    Announcements: 

    The Health Room will welcome donations for the following: 
    NEW underwear and socks of all sizes (5T - Big Kid XL)
    We also welcome donations of clothing per seasons, please call the Health Room to see if we are in need of the sizing you are gifting. 
    * Please send your student with a change of clothing including underwear and socks labeled to keep in their classroom. 

    Required Immunizations:

    https://health.maryland.gov/phpa/OIDEOR/IMMUN/Shared%20Documents/2025-2026_Preschools_and_Schools_Vax_Requirements_Final.pdf

    https://ww2.montgomeryschoolsmd.org/departments/forms/pdf/mdh_896_form.pdf

    Required Medical Forms:

    SR 6 Health Assessment:  

    https://ww2.montgomeryschoolsmd.org/departments/forms/pdf/sr-6.pdf

    https://ww2.montgomeryschoolsmd.org/departments/forms/pdf/sr-6_spanish.pdf

    Lead:

    https://ww2.montgomeryschoolsmd.org/departments/forms/pdf/dhmh%204620.pdf

    Dental: 

    https://ww2.montgomeryschoolsmd.org/departments/forms/pdf/525.17.pdf

    https://ww2.montgomeryschoolsmd.org/departments/forms/pdf/525-17_spanish%2023.pdf

    Forms:

    Authorization to administer medication:

    https://ww2.montgomeryschoolsmd.org/departments/forms/pdf/525-13.pdf

    https://ww2.montgomeryschoolsmd.org/departments/forms/pdf/525-13_spanish.pdf
    Authorization to provide medically prescribed treatment: 

    https://ww2.montgomeryschoolsmd.org/departments/forms/pdf/525-12.pdf

    https://ww2.montgomeryschoolsmd.org/departments/forms/pdf/525-12_spanish.pdf

    Emergency care for Managment of Anaphylaxis: 

    https://ww2.montgomeryschoolsmd.org/departments/forms/pdf/525-14.pdf

    https://ww2.montgomeryschoolsmd.org/departments/forms/pdf/525-14_spanish.pdf

    Asthma:

    https://www.montgomeryschoolsmd.org/siteassets/schools/high-schools/k-q/northwesths/uploadedfiles/news/schoolasthmamgtplan1.pdf

    https://www.montgomeryschoolsmd.org/siteassets/schools/high-schools/k-q/northwesths/uploadedfiles/news/mcdhhs-3213a-asthma-action-plan.pdf

    Special Dietary Needs: 

    https://ww2.montgomeryschoolsmd.org/departments/forms/pdf/240-23.pdf

    https://ww2.montgomeryschoolsmd.org/departments/forms/pdf/240-23_spanish.pdf

    Authorization to provide gastrostomy tube feeding: 

    https://ww2.montgomeryschoolsmd.org/departments/forms/pdf/525-15.pdf

    More resources: 

    https://www.montgomeryschoolsmd.org/departments/studentservices/mentalhealth/school-health-services/