Health Services

At the North Shore Hebrew Academy, we are committed to keeping our students healthy and safe. Below is where you’ll find important school policies, referral forms, and health notices.

NSHA Nurse Contact Information

CHERRY LANE (Grades PreK-5)
Tel: (516) 487-8687 Ext. 115
Direct Fax: (516) 487 – 5565

Tanaz Banilivi, R.N.
TBanilivi@nsha.org

Mrs. Gonzalez, Assistant to the Nurse
lgonzalez@nsha.org

OLD MILL ROAD (Grades 6-8)
Tel: (516) 487-9163 Ext. 215
Fax: (516) 829-3933

Mrs. Swerdlin, R.N.
BSwerdlin@nsha.org

Health/Medical Information (STUDENT)

100 Health History

110 Pre-School Lead Screening Requirement

104 "B" Form and NYS Concussion Information

102 Physical Exam Form

109 Confidential Health Concerns

105 Dental Health Report

200 - Immunization Forms

200 Immunization Record

202 Immunization MMR#2 Requirement

203 Immunization Chicken Pox Requirement

204 Immunization Tdap Requirement

300 - Medication Forms

300 NYS Guidelines for Administration of Medication

301 Parent Authorization for Medication

302 Physician’s Order-Parent Authorization for Medication

303 Self Medication Release Form

400 - Referral Forms

401 Vision Referral

402 Vision Referral Update

405 Hearing Referral

407 Scoliosis Referral

500 - Assistive Device Forms

501 Guidelines for Protective/Assistive Devices

502 Guidelines on Using Crutches

503 Assistive Device Note – Parent

700 – Exposure Notices

710 Chicken Pox

711 Conjunctivitis

712 Coxsackie Virus

713 Fifth Disease

715 Shigellosis

716 Pediculosis

717 Streptococcal Infection

900 – Miscellaneous

904 Elementary Health Office Numbers

905 Release of Confidential Information

Department of Health Survey Parent Letter

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