City of Manchester, NH Official Website

School Health

The School Health Division is staffed by professional school nurses and health assistants committed to the youth of Manchester.

School nurses share in the day to day responsibility of protecting the health of individuals in the Manchester Schools and in the community. They are responsible for determining health status of students, promoting healthy behaviors, identifying unmet health needs, and providing interventions to meet those challenges.

The services provided by school nurses meet the objectives of the Health Department for disease prevention, health promotion and community health planning activities. They provide ongoing health supervision for all public school children in pre-school through grade 12.


The School Health Staff:

  • School Nurse at McDonoughBelieves that each child has the right to access school health services, whenever needed.
  • Believes that a solid partnership must be maintained with families on behalf of the child.
  • Believes the family is most important in the development, implementation and evaluation of each child's school health plan. Parents or guardians are informed of state regulations for immunizations and physical examinations and of health services available in the community.
  • Believes the nurse is a caring professional and will respect the confidentiality of the student/client while functioning as a student advocate within the school, family and community setting.
  • Believes that school nurses are health teachers by virtue of their experience/education and as defined by the New Hampshire Nurse Practice Act. Health teaching or health counseling occurs in the Health Offices, in classrooms, and with families.

School Health Services

  • First Aid and Illness Care: The school nurse provides emergency care for illness and injuries. Using physical assessment skills, the school nurse will determine the nature of the illness or injury and initiate appropriate interventions. Parents will be notified if necessary.
  • Health Records: Health records are maintained on each student. These records are confidential and kept throughout your child’s school career. Health records include information on immunizations, physical examination reports and individualized health condition plans.
  • Screening Program: Screenings are completed according to the NH Department of Education recommendations. These include vision, hearing testing, height/weight, and Body Mass Index, dental or oral exam and general health assessment and history information. If you wish that your child be exempt from any screenings please notify your school nurse.
  • Health Education and Health Counseling: Individual and classroom health education is provided in each school on nutrition, heart health, growth, development, and general health maintenance. Counseling for health concerns is provided for students and their parents as needs occur. The School Nurse follows up on health problems and will make referrals to appropriate agencies as needed. With the parent’s permission, the school nurse will consult with the child’s primary health care provider (or outside agency).
  • Care of Children with Special Health Care Concerns and the Individual Student School Health Plan: Enrollment of students with health care needs in the school setting presents a challenge to students, families, and school staff. The school nurse acts a partner with families and providers to help create a plan when some children require special health care during the school day. A school health plan is developed to meet the individual health needs of students with special health concerns. If your child has a chronic illness (such as asthma, attention deficit hyperactivity disorder, diabetes, seizures) please meet with the school nurse to develop the best Health Plan for managing health needs during the school day.
  • Medication Administration: If a child needs to take medication during the school day the nurse is available to administer it. Medications must be in the original prescription bottle labeled with the student’s name. All medications require written parent permission and a written physician/healthcare provider order. Please contact your school nurse for the required forms or see our link to forms at the left of this page.

School Entry Requirements

NH State Law requires that documentation of the following must be provided prior to school entry:

RSA 200:32 A complete medical examination by a licensed physician, physician assistant, or advanced registered nurse practitioner before entrance into the public school system and thereafter as often as deemed necessary by the local school authority.

Physical Exam: Effective SY 2008-2009 the Manchester School Department requires a physical exam upon entry into kindergarten or grade 1, and grades 6 and 9. We need written signed documentation of this exam. You may print the form from our form section (at left) or we accept forms from individual health care providers. We encourage regular visits to your child’s health provider during school age years to monitor your child’s growth and development.

RSA 141-C:20-a Immunizations: All parents or legal guardians shall have their children who are residing in this state immunized against certain diseases. Medical and Religious Exemption information is available at:

RSA 200:38-1 All children shall be immunized prior to school entrance in accordance with RSA 141-C:20.

New Hampshire
School Immunization Requirements 2017-2018

  1. Children must have proof of all required immunizations, or valid exemptions, in order to attend the first day of school. Documentation of immunity by confirming laboratory test results is acceptable.
  2.  A child may be conditionally enrolled when the parent or guardian provides: (1) Documentation of at least one dose for each required vaccine and (2) The appointment date for the next dose of required vaccine. (He-P 300.13)
  3. All immunizations must meet minimum intervals and age requirements for each vaccine. A 4-day grace period is allowed; however, live attenuated vaccines not administered on the same day should be administered at least 28 days apart.
  4. Medical and religious exemption information is available at:


6 years and under: 4 or 5 doses, with the last dose given on or after the 4th birthday.
7 years and older: 3 or 4 doses, with the last dose given on or after the 4th birthday.
11 years and older: A one-time dose of Tdap. If child turns 11 on or after the first day of school, they are required to have Tdap prior to first day of the next school year. A dose of Tdap at age 10 is acceptable.


Grades K-4: 3-4 doses with one dose on or after the 4th birthday, with the last
  two doses separated by 6 months.
Grades 5-12: 3 doses, with the last dose given on or after the 4th birthday2
  or 4 doses regardless of age at administration.2

Hepatitis B  

Grades K-12: 3 doses at acceptable intervals.


Grades K-12: 2 doses required; the first dose must be on or after the first birthday.


Grades K-8: 2 Doses2, Grades 9-12: 2 Doses3; the first dose must be on or after the first birthday.

1If the child has a medical contraindication to pertussis vaccine, the child shall receive Tetanus diptheria toxoid 
     (Td/DT) vaccine.
2If a combined IPV/OPV schedule was used, 4 doses are always required, even if the 3rd dose was administered
      after the 4th birthday.
3Varicella vaccination or laboratory diagnosis of chicken pox disease is required.
4 Varicella vaccination or history of chicken pox disease.

See additional School Health Forms for more information.

Please contact your child’s health care provider to obtain the required immunizations.

If your child does not have a health care provider, immunizations may be obtained at no cost at:

Manchester Health Department 1528 Elm Street

on the following days and times:


Monday 1:30 p.m. – 3:30 p.m.

Tuesday 9:00 a.m. – 11:30 a.m.

Thursday 3:00 p.m. - 6:00 p.m.

A parent or legal guardian must accompany persons under 18 years of age.

Injury and Illness Management

All school personnel have a responsibility to provide and foster a safe and healthful school environment.  A complete set of guidelines and policies are established to handle emergencies and most common childhood complaints.

In the event of injury or sudden illness the school nurse and/or a designated staff person is responsible for providing emergency care. The school nurse directs necessary interventions and notifies parents and the school administration.

In an extreme emergency the school nurse and building administrator may make arrangements for immediate transportation of an injured or ill student to the Emergency Room, contacting parents or guardians in advance if at all possible.

Cardiopulmonary Resuscitation, First Aid, and AED certification classes are offered throughout the school year.  These classes, open to any school staff member and city employee, are taught by the Certified School Nurse staff.  To register, please call the West High School Nurse at (603) 624-6386.

Dismissal Policy

Protecting the health and welfare of all children in the classroom is our primary concern. The school nurse will use professional judgment to determine if it is necessary to dismiss any child from school for injury or illness.

The school nurse may exclude any child from attending class who presents with symptoms of a contagious disease that poses a significant risk to other students or staff.

No young child who is ill or injured shall be sent home alone and older children may be dismissed home alone if the injury/illness is minor and a parent or guardian has been notified.

Should I Send My Child To School?

Parents are frequently faced with the decision of whether or not they should send a child to school. Here are some "illness indicators" to keep in mind.

  • Children with fevers of 100.5 degrees F or above are generally not feeling well and should stay at home. Most fevers indicate the bodies’ response to illness.  Most children with a fever feel sick. Rest at home until fever is gone is the best plan and then return to school.  If a fever lasts longer than 3-4 days, does not respond to over-the–counter fever medicines, or is accompanied by other severe symptoms, you are advised to call your health provider. 
  • Diarrhea, nausea, or vomiting, are clear signs that children need to stay home.  Severe cramping with diarrhea or nausea with vomiting that lasts for several hours may cause dehydration, especially in small children.  During periods of acute illness, sipping water or sucking on ice cubes may be useful. If a child appears very sluggish, pale, sweaty, or the skin is red and hot, contact your health provider for more instructions.
  • Colds are caused by viruses causing headache, runny nose and cough and last for 5-7 days. Transmission is by hand to hand contact and through the air after sneezing and coughing. Viruses can live on surfaces of objects for many hours and are very contagious.  Children can be uncomfortable the first few days but then start to feel better.

    However, call your health provider if your child has symptoms of:
    • severe congestion accompanied by fever and headaches, and lasting more than 10 days;
    • a cough that keeps a child (and you) awake for a few nights;
    • nasal discharge lasting longer than 10 days, that is dark green or yellow, thick and foul smelling;
    • severe ear pain; very sore throat that makes it difficult to swallow;
    • yellow or green eye discharge with redness; skin under the nose that becomes scabbed or crusted yellow.

One Final Note: Instruct your child to use and dispose of tissues promptly, wash hands often, and consider keeping your child home in the first day or two.

Some contagious diseases that necessitate a child’s exclusion from school are: chicken pox, strep (streptococcal) infections of throat/skin; influenza; conjunctivitis caused by bacteria; contagious skin rashes, such as impetigo; and others (as determined by NH Department of Health and Human Services; communicable disease guidelines He-p 301.02.

School Head Lice

The School Nurse will:

  • Identify head lice by the presence of live lice or nits and contacting parents.
  • Educate parents, families and community on head lice prevention.

The best way for schools to get control of lice is for every parent to check every child frequently, and report to the school if lice or nits are found. Schools are only one place your child may contact lice: consider other places where your child is in contact with other children such as baby sitters, child care, church, clubs, family visits, sleepovers. These are all possible places where lice can spread.

The Bottom Line

  • Treat with a medicated shampoo as directed.
  • Remove all nits with comb or fingernails.
  • Wash clothing, bedding, etc, in HOT water and pack away non-washable items for 2 weeks.
  • Check heads daily for at least a week for nits and remove nits .If you see live lice, do not repeat the lice shampoo.
  • Repeat treatment in 7-10 days (as directed).
  • Let your school nurse know! - and call with questions!

Head Lice - The Basics

Head Lice Brochure

For more information on Head Lice Treatment visit Centers for Disease Control and Prevention.

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