Health Office

School Nurse: Mrs. Larisa Ippolito, RN
email: [email protected]
Phone: (732) 431-4403 Ext: 2108

Welcome to the Barkalow Health Office



The NJDOE and the American Academy of Pediatrics have not changed immunization schedules and requirements due to the COVID-19 pandemic. Please contact your pediatrician to discuss scheduling the necessary vaccines.

  • If your child will turn eleven before August 24, 2023 then you must show proof of these immunizations in order for your child to receive their class schedule in September.
  • If your child will turn eleven on or after August 24, 2023, they will receive their 6th grade schedule but they will be excluded from school if the immunizations are not administered within two weeks from their birthday.
Proof of immunizations must be signed by your child’s physician or advanced practice nurse and returned to your current school nurse. After June 20, 2023, immunization forms may be dropped off at the Barkalow Main Entrance mailbox or can be mailed to your school nurse.


All medications administered by the school nurse require a physician's order and parental consent form to be submitted to the Health Office.  These must be resubmitted each school year.  See sidebar for forms.

  • Allergy Action Plans are required for life-threatening allergies
  • Asthma Action Plans are required for inhalers (including self-administered). 

EpiPens with a dose of antihistamine/Benadryl, and inhalers are the only medications that students may carry and self-administer, per New Jersey law. 

  • Please complete a Medication Order form for other necessary medications that will be stored in the Health Office and administered by the Nurse. 


Pre-Participation Physical Evaluation Information

All athletes are required to submit a physical exam once every 365 days. Please read below for details. See sidebar for required sports physical packet. ALL Athletes: Submit a paper copy only! No email copies or faxes will be accepted. Please be sure all yes answers on the history are explained with ages and dates!

STUDENTS MUST COMPLETE PAPERWORK FOR EACH SEASON (Fall/Winter/Spring) by the stated deadline for sports and intramurals. ALL incoming 6th graders interested in Fall Sports must submit a new sports physical packet by the deadline.


***Fall Sports: AUGUST 25, 2023***

Winter Sports: October 31, 2023

Spring Sports: February 27, 2024 

Please DON'T Be Late!

**Beginning 7/5/23 Completed Fall sports physicals and immunizations can be dropped off at the Barkalow Main Entrance mailbox. Tuesday-Thursday 8:30am-4:00pm.


Exams conducted on or after 3/13/23 are acceptable for the SPRING 2024 season. 


The Annual Athletic Pre-Participation Physical Examination Forms are required by the New Jersey Department of Education. These forms are required for any middle or high school student in New Jersey who wants to participate in an interscholastic or intramural sports program. Students must have their exam approved by the school doctor before they can participate in practice or tryouts. Our school doctor is scheduled in advance to review all the sports physicals for the entire district. Forms that are submitted late or incomplete can not be guaranteed to be approved by the school physician before the season starts. Students who have not received clearance by the school doctor may not participate in any practice or tryout. Please adhere to all deadlines and guidelines to assure that your child is able to participate.  


  • Must be completed in full by the parent/guardian.
  • Must explain all 'yes' answers; include dates, length of symptoms and treatment. You may attach a second piece of paper if more room is needed.
  • The parent/guardian and student must sign and date.
  • The date on the History form must be the same date as the physical exam *This form must be reviewed by the health care provider at the time of examination


  • Must be completed in full by the health care provider.  
  • Both forms must be signed, stamped and dated by the health care provider.
  • All “indicators” must be filled in by the examiner; this includes height, weight, blood pressure, pulse and vision.
  • Health care provider signature in the Cardiac Assessment Professional Development section.
  • Incomplete forms will be returned for completion by your health care provider per New Jersey Administrative Code.
  • Exams conducted on or after 3/13/23 are acceptable for the SPRING 2024 season.

Complete on Genesis Parent Portal EACH SPORT SEASON

  • Health History Questionnaire

Complete on Genesis Parent Portal ONCE PER SCHOOL YEAR

  • Concussion form
  • Opioid Fact Sheet
  • Sports Related Eye Injuries
  • Sudden Cardiac Death Pamphlet
(See attachment below for Spanish version)
As you are aware, the State of New Jersey has revised the laws regarding school attendance. In order to be in compliance with these laws, the Freehold Township Schools have created board policy to govern student attendance in Freehold Township. A summary of the policy can be found in the student handbook you received in September.

School board policy requires that the school receive a written note for each school absence with the parent's original signature. This note should state the date and reason for absence. We have created a form which may make it easier for you to fill out and send in the required information. You can complete the form in place of a note and return it the day your child returns to school. Immediately following any future absences, you can always refer to this site to access the form or you may write an absence note to your child's teacher. We appreciate your cooperation with this policy.
See Below for Absence Form

CTB Absence Form

Sports Forms
Human Papillomavirus:
Information from the New Jersey Department of Education
Sudden Cardiac Death Brochure