Health Requirements & Policies

Annual Physical Exam Requirements

ALL students are required to receive a physical examination between April 1 and August 1 preceding each new school year. As part of this physical, the medical doctor (MD), doctor of osteopathy (DO), physician's assistant (PA), or nurse practitioner (NP) is required to complete and sign several of our heath forms. Within our health forms packet, you will find a checklist that will help you know which of our forms need to be signed by the medical provider after the physical exam.

We understand that your health insurance may not cover a physical examination if it is completed before the one-year mark since your child's last exam. However, in order to meet our state-required deadlines, we ask that you move forward with getting your child's physical examination during the April 1 to August 1 window each year, either by paying out-of-pocket (without using insurance), or by visiting your local medical aid unit, emergency room, or clinic, where you may be able to pay a flat fee.

Please note that it is NOT acceptable for students to arrive on campus without a physical examination and with incomplete health forms. We appreciate your understanding and cooperation in meeting these deadlines and requirements.

Emergency Action Plans

If your child has a history of asthma, severe allergy or anaphylaxis, or seizure disorder, please have your doctor complete the appropriate Emergency Action Plan for this condition. Emergency Action Plan forms are included in our health forms packet and can be found below.

Insurance Requirements

Out of concern for the health and welfare of all our students, St. Andrew's School requires that every student be covered by a comprehensive injury and medical insurance plan, one that covers your child in the State of Delaware and provides a United States address and phone number for claims and customer service. Travel insurance is NOT accepted as medical insurance, due to inadequate medical coverage. For more information on whether or not your insurance plan will provide adequate coverage in the State of Delaware, see our Determining Your Away-From-Home Coverage section below.

It is the responsibility of the parent or guardian to obtain referrals for your child if and when they are needed, and to follow through in a timely manner with all insurance paperwork as it arises, including the submission of claims.

Any student who cannot provide proof of medical insurance with appropriate coverage must enroll in the Plan I insurance offered by St. Andrew's. For more information on this plan, visit our Insurance Plans page.

Insurance Cards Requirement

The Health Center is required to fax a copy of the front and back of all pertinent insurance cards, as well as the Student Information & Medical Authorization form (Page HCF-1 of our health forms packet) and the Insurance and Care Provider Information form (Page HCF-3 of our health forms packet) to a medical provider prior to a student's appointment with that provider. It is very important that you provide us with an ENGLARGED copy of both the FRONT and BACK of all insurance cards (health, prescription, and dental), and that you write legibly and provide all requested information on each of these forms. The Health Center will also accept the actual insurance card(s), if you would prefer to obtain an extra card from your insurance company.

Insurance Changes During the School Year

If your health insurance changes at any time during the School year, it is the parent or guardian's responsibility to send us the updated insurance information for your child. We require an ENLARGED copy of the FRONT and BACK of the new or updated insurance card(s).

Determining Your Away-From-Home Coverage

As a parent or guardian, it is your responsibility to contact your insurance company to confirm that your insurance plan will cover your child in the State of Delaware. Some insurance companies provide away-from-home coverage, while others may provide out-of-network coverage, but at a higher cost. Talk with your insurance company about what medical benefits will be curtailed, and what deductibles and co-payments will be required, if any, when your child receives care away from home.

When contacting your insurance company, please be sure to refer to our Medical Resources Contact List so that both you and your insurance company know exactly which medical providers (doctors, dentists, orthodontists, labs, etc) we use in our area. The Health Center uses only these specified local medical providers. We cannot and will not make appointments and transport students to medical providers of your choice.

If your plan provides away-from-home coverage:

If your medical insurance provides adequate away-from-home coverage for your child, you will need to complete the top portion of the Health and Accident Insurance form, which can be found on Page HCF-2 of our health forms packet.

If your plan does NOT provide away-from-home coverage:

For those parents whose medical insurance does not provide adequate away-from-home coverage for their child, St. Andrew's School offers two different insurance plans. Please visit our Insurance Plans page for more information on your options.

HMO Plans

If your insurance is an HMO plan, your child is only able to be treated by the primary care physician listed on your policy. Therefore, if your child will require medical attention while at St. Andrew's, he or she will be taken to the local medical aid unit or emergency room. Please review the insurance plans offered by St. Andrew's.

Medicaid Plans

Medicaid plans do not provide adequate coverage outside of their home state. If you have a Medicaid plan, please contact the Health Center at 302-285-4240 to discuss coverage options for your child.

International Insurance

If you have international insurance that provides domestic claim coverage, you must provide the Health Center with a United States address and phone number for this insurance carrier. Our medical providers do NOT accept insurances with international addresses and phone number. We recommend that international students purchase our Plan I insurance through St. Andrew's, or purchase a domestic insurance plan from a reputable agency. Travel insurances are NOT accepted due to inadequate medical coverage.

Medication Policies & Requirements

Prescription and over the counter (OTC) medications are not allowed on dorm. For the health, safety and welfare of our students, these medications must be supervised and administered by the nurses at the Health Center.

For certain medical conditions, the Director of Health Services will make exceptions for the following medications:

  • Inhalers;
  • Nebulizers;
  • Epi-Pens;
  • Female hormones (birth control pills);
  • Creams or ointments for acne and other skin conditions;
  • Ear or eye drops;
  • Lactaid; and
  • Vitamins.

The Director of Health Services must approve these medications BEFORE they may be kept on dorm. It is a violation of a major school rule for students to possess, distribute or use prescribed and OTC medications in their rooms without the knowledge and permission of the Director of Health Services. It is also a major violation of our alcohol/drug rules for a student to use prescription medication as a recreational drug or for students to use over-the-counter medications in an abusive manner.

If the Health Center is asked to administer vitamins, a doctor’s order is required. Any unapproved medications found on dorm will be confiscated and the Headmaster will be notified.

The nurses will administer prescription medications as prescribed by the students’ physician. If the student does not take their medication, an email will be sent to the Student, Advisor, Parent and Counselor (if assigned).

Students are not permitted at any time to keep controlled substances, narcotics, stimulants, psychotropic or anti-anxiety medications, or medications that cause drowsiness on dorm.

Procedure for scheduled medication

Any prescription medications not listed above are to be kept in the Health Center at all times. Students must come to the Health Center to take these prescription medications, as well as certain over-the-counter medications. The School nurse will administer prescription or over-the-counter medication to students if the following requirements are met:

  • For prescription medications, a current prescription is required.
  • International prescriptions or medications are not acceptable.
  • Verbal prescriptions are not acceptable.
  • All medication must be checked in to the Health Center as soon as the student or parent carrying the medication arrives on campus.
  • All medication must be received by the Health Center in its original container.
  • The label on the prescription medication must include the correct: student name, medication name, dosage, time, and route.
  • Any changes to the instructions on the label must be received in writing from the associated health care provider.
  • Controlled substances will be counted during intake to the Health Center.

If a student falls to come to the Health Center for a scheduled medication, an email reminder will be sent to the student, and to his or her parent or guardian, academic advisor, and counselor (if assigned). Marks may be given for unexplained missed doses of prescribed medication, unless there is a legitimate reason for missing the dosage. Legitimate reasons include: nausea or vomiting; untoward side effects; or being away from campus for a home or college visit. Medications can be obtained from the Health Center after returning from an away sporting event or other off-campus activity.

Procedure for As-Needed Medication

Students may come to the Health Center at any time for over-the-counter medications stocked by the Health Center, if a permission form is signed. A written order from a health care provider is required to change a scheduled medication to an as-needed medication.

Medication Policy for School Breaks

During School breaks, all medications are sent home with the student. If there are any medications that the student and/or parent or guardian does not want sent home, please notify the Health Center in a timely manner. Discontinued medications or prescriptions that are sent home should remain at home. It is the responsibility of the student to turn in all medication(s) to the Health Center as soon as he or she returns to campus (parents and guardians can also return medication to the Health Center, but the student will be held accountable for any medications not turned in).

Accutane Therapy

Students on Accutane Therapy must provide the Health Center with monthly prescriptions for routine lab work and medication refills. If a student will be seeing a Delaware dermatologist while on campus, parents should make appointments well in advance, and inform the Health Center of the date and time of each appointment. The Health Center will provide transportation if necessary, and the student will be charged accordingly.

Local Pharmacy

Our primary pharmacy is Acme Sav-On Pharmacy, located at 460 East Main Street in Middletown. Phone: 302-449-1868; fax: 302-449-1876.

Off-Campus Medical Appointment Policies

The Health Center will make appointments and provide transportation to local medical providers for sick or injured students. Our medical providers give us the first available appointment, but this does not always guarantee same-day service. (Please see the Sick or Injured Students section of this page for more information.) The Director of Health Services has the authority to deny requests for non-urgent transportation to medical providers if those requests create a disruption to the daily operations of the Health Center.

We request that parents make arrangements for any visits to sub-specialists—such as dermatologists; ear, nose, and throat (ENT) doctors; cardiologists; pulmonologists; or allergists—while the student is at home during School breaks. If a student has an appointment at home while School is in session, the parent must notify the Health Center AND the Dean's Office prior to the date of the appointment. Non-urgent speciality appointments will be arranged locally and secondary to the daily operations of the Health Center only when said appointment cannot take place at home. A $5 fee per appointment may be billed to the student's miscellaneous billing account to cover transportation provided for any and all speciality appointments within the Middletown area, including physical therapy and chiropractic appointments.

In the event that your child needs to see a specialist and a referral is needed from his or her primary care physician, it is the responsibility of the parent or guardian to make the necessary phone calls to secure the referral before the speciality appointment can be made for the student.

Healthcare Providers

Healthcare providers are available to students by appointment only, at their respective offices. Please refer to our Medical Resources List for the providers we use. Our School physicians, all of whom practice with Nemours Pediatrics Middletown, require all parents and guardians to complete two forms prior to treatment of a student. These forms will be emailed or faxed to you prior to your child's medical appointment, and include:

  • Authorization for Treatment and Release of Information for Treatment, Payment and Health Care Operations Purposes form; and
  • Financial Responsibility and Assignment of Benefits form.

Nemours Pediatrics will not see the student until their office is in receipt of these two signed forms from the parent or guardian.

Sick or Injured Students

Students are admitted to the Health Center when they are at risk of spreading infection to other students, or are sick or injured to a degree that warrants monitoring by a nurse. Parents and guardians will be notified when students are admitted to the Health Center for more than 24 hours.

If a student needs medical attention from one of our medical providers, the Health Center will contact the parent or guardian. A School driver or staff member will transport sick or injured students to necessary medical appointments. Transportation costs for appointments outside the Middletown area are as follows:

  • $40 for appointments in Hockessin, Wilmington, Newark, Glasgow, Smyrna, Dover, and surrounding areas;
  • $50 for appointments in the Philadelphia area; and
  • $80 for appointments in the Baltimore area.

If a student admitted to the Health Center requires more than two days of 24-hour care, the Director of Health Services may require that students residing within driving distance of St. Andrew's be sent home to continue care under the supervision of their parent or guardian.

When a student is returning to school after being home due to illness or injury, the student must check in with the Health Center FIRST, before returning to dorm and resuming School activities.

Please note that it is important that parents and guardians notify the Health Center if a student becomes sick, injured, is hospitalized, undergoes surgery, or receives vaccinations at any time after the annual submission of our health forms, or during a School break.

Medical Leave

Medical leaves from school are intended to address a student's health, which is the priority, and to provide the necessary amount of time for the important recovery process. Medical leaves are always open-ended, since we do not know or cannot predict when a student will be well enough to return to School. The final decision regarding when a student may return to School rests with the Headmaster, Director of Counseling, and the Director of the Health Center. Please note that specific guidelines and requirements for medical leaves are listed in our Medical Leave protocol form, which will be given to the parent or guardian of a student if and when the student is sent home on medical leave.

Whenever a student returns from any type of medical leave, the student must check in with the Health Center upon arrival to campus. They are not permitted to return to dorm, class or resume school activities until they have check in with the Director of Health Services. At that time, any prescription or over the counter medications that the student is taking must be turned in at that time.

Surgeries & Hospitalizations

All students are required to recover from any and all hospitalizations, surgeries, or serious illnesses at home. This is to protect the recovering student from being exposed to potentially infectious diseases. The Health Center is not staffed for post-surgical or long-term care.

Concussion Policy

Whenever a student has symptoms of a concussion, he or she is required to see a medical physician. If a student is diagnosed with a concussion during that examination, he or she may be required to take medical leave to recover from the concussion at home.

Vaccination & Immunization Requirements

As required by the State of Delaware, ALL students attending St. Andrew's must have the following vaccinations and immunizations:

  • Four doses of any combination Diphtheria, Tetanus, Pertussis (Tdap, DT, Td) vaccine. One of these doses must be a Tdap.
  • Four doses of Polio vaccine (three doses if the third dose was given on or after the 4th birthday);
  • Two doses of Measles, Mumps, Rubella (MMR) vaccine on or after 12 months ago;
  • Three doses Hepatitis B vaccine; and
  • Two doses of Varicella vaccine (unless history of disease).

As of August 2016, all entering III Form students (that is, the Class of 2020) must additionally have one dose Tdap (adult booster) and one dose Meningococcal vaccine. In August 2017, these two additional vaccines will be required for all entering and returning III and IV Form students; in August 2018, for all entering and returning III, IV, and V Form students; and in August 2019, for all entering and returning III, IV, V, and VI Form students (i.e. all students).

If the student is missing any required vaccines, the parent or guardian will be contacted by the Health Center. It is the responsibility of parents and guardians to comply with the State of Delaware and with St. Andrew's School policy with regard to these required vaccinations and immunizations. If requested by the parent or guardian, the Health Center will arrange for the student to receive the missing vaccine(s) from one of our medical providers. The parent or guardian will be responsible for all costs incurred by this process.

Recommended Vaccinations & Immunizations

The following vaccinations and immunizations are recommended for students but are NOT required:

  • Two doses of Hepatitis A vaccine;
  • Two doses of Meningitis vaccine;
  • Three doses of Human Papillomavirus (HPV) vaccine.

Travel Vaccinations & Immunizations

A medical provider will administer any travel vaccinations or immunizations that are requested by parents and guardians. Parents and guardians are responsible for the cost of these immunizations and associated travel fees.

For more information about vaccinations and immunizations, visit the Center for Disease Control and Prevention website.

Other Health Policies


If your child requires the use of an Epi-Pen for his or her allergy, an Anaphylaxis Emergency Action Plan for your child must be on file with the Health Center. Please ask your child's physician to provide this plan. Upon approval by the Health Center, the student may keep an Epi-Pen in his or her room. A spare Epi-Pen will need to be kept in the Health Center as well.

Food Allergies

If you child is allergic to a certain food or foods, these must be listed on Page HCF-1 of our health forms packet. The Health Center then shares this information with our Dining Services staff.

Medication Allergies

If your child is allergic to medications, it must be listed on Page HCF-1 of our health forms packet. The Health Center then shares this information with our medical providers.

Seasonal Allergies

If your child suffers from any seasonal allergies, please list these on Page HCF-1 of our health forms packet. Please note that it is not uncommon for a student who has never before suffered from seasonal allergies to experience them during the fall or spring.

Allergy Injections

Allergy injections will only be administered to students under the care of an allergist. The allergist must give the initial allergy injection, as well as any changes or additions to the immunotherapy schedules. There is a $10 charge for each allergy injection administered by a Health Center nurse.

Contact Lenses & Eyeglasses

Please send an extra pair of eyeglasses, set of contact lenses, or current prescription for new lenses to School with your child, in the event that his or her eyeglasses or contact lenses become broken, torn, or misplaced.

Flu Vaccine & Policies

Our students and faculty live and breathe in such close proximity to one another. In the boarding school environment, students share everything—including their illnesses! For this reason, the Health Center offers and administers the flu vaccine to students, faculty, and staff each fall term (beginning in late September or early October). Nurses administer the flu vaccine under the direction of the School Physician. In order to ensure that we maintain a healthy campus throughout the entire School year, we highly recommend that all students receive a flu vaccine.

Students who receive the flu vaccine from the Health Center will be charged a $10 fee, which will be billed to the student's miscellaneous billing account. Parents and guardians must fill out and sign the Flu Vaccine Form, which is included in our health forms packet. Please note that the Health Center does NOT administer the flu mist (nasal spray). We only offer the flu vaccine that is injected into the arm.

If a student prefers to receive his or her flu vaccine at home, this can be done before the School year begins, or during the Long Weekend in October. The Health Center requires documentation from the medical provider as to which type of flu vaccine the student received and the date that it was administered.

During the flu season, the Health Center may reach full capacity; on these occasions, students who reside in the Tri-State area may be sent home to recuperate.

For up-to-date information on the current year's flu vaccine, visit the Center for Disease Control and Prevention website.

Potassium Iodide Information

Potassium Iodide (KI) is a form of iodine found in iodized table salt. If taken in time and at the appropriate dosage, KI protects the thyroid gland from exposure to radioactivity during a severe nuclear emergency, and reduces the risk of developing thyroid cancer as a result of that exposure.

In the event of any radiation threat or exposure, students will be given KI only if the School is directed to do so by a public health official. All parents and guardians are required to complete and sign the Potassium Iodide Tablets Form included in our health forms packet, which can be found on Page HCF-4. Everyone, including children and babies, can take KI except for those who are allergic to iodine, or have rare disorders such as dermatitis herpetiformis or hypocomplementeric vascultitis. If your child has a known or suspected allergy to iodine and/or a rare disorder that prevent the taking of KI, please consult with your child’s doctor before giving consent for them to receive KI.

While KI can help to protect the thyroid gland, it cannot protect against other health effects caused by radiation. However, in the event of a nuclear emergency, protecting the thyroid gland from radiation exposure is especially important for children. KI has few side effects, and children are not at a higher risk for side effects. Side effects usually occur when people take more doses of KI than necessary. Possible minor side effects include skin rashes, swelling of the salivary glands, metallic taste, burning mouth, sore teeth or gums, upset stomach, diarrhea, and headaches. If you take KI and experience severe side effects or a severe allergic reaction, call a doctor or go to the nearest hospital.

For additional information about KI, please contact your local pharmacist or healthcare provider.

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