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Health Forms

K-12 Emergency Authorization and Permission to Treat Form

K-12 Severe Allergy Form

K-12 Prescription Medication Form

All students participating in TVS Athletics (including cheer, dance and PE) in grades 7-12 are required to have a pre-participation physical examination performed by a physician to determine if they are physically capable of participating. To better align with preventative healthcare and best practices a new physical exam is required every year. In addition to the physical exam, each parent and student should complete the “Pre-Participation Medical History” form on RenWeb. This form will give the TVS Medical Staff a more detailed and complete picture of your child’s health history. The Pre-Participation Medical History form includes; a Permission to Treat Acknowledgement, a HIPPA Statement, and Concussion Acknowledgement Statement. The Pre-Participation Medical History form should be completed annually through RenWeb.  No student will be allowed to participate in any TVS activity without completing and returning their pre-participation physical examination and online medical history form. Please submit the completed pre-participation physical exam to the Athletic Trainers prior to your child’s sport or activity begins. You can submit the forms via Fax #817-321-0161, email, or deliver to the Athletic Office to ATTN: Athletic Trainers.


June 10, 2016 

TVS Parents,

I hope you are having a fantastic start to your summer! I wanted to send out some reminders and provide dates for documents and records that will be required prior to your child’s return for the 2016-17 school year. This was my first year here at TVS and I feel truly honored to get to care for your children and keep them safe while at TVS!

As we dive into the next school year, I hope to provide you with a health flash every few months to keep you updated on health news, preventative measures, and tips on how you can help. This year, we survived the stomach bugs, lice, strep throat, viral illnesses, pink eye, seasonal allergies to the extreme, and a very late flu season. I also hope to provide more education to your children throughout the school year on how they can help reduce the spread of illnesses and protect themselves. Handwashing is of course the most important step in staying healthy!

Whether your child is due for immunizations or not, I will need a new immunization record for each of your children, no matter what grade they are entering. I know that many of them will not be due for immunizations, but I still need a new copy. This is a Texas state requirement, and you can view the Texas Minimum State Vaccine Requirements for Students Grades K-12 at:

In addition to the immunization records, I will also need a completed and signed Emergency Authorization and Permission to Treat form for each child. In the past, TVS required parents to submit this document only once, when their child(ren) first enrolled. But now I will need a new one each year for the entirety that your child is here at TVS.

If your child has a food allergy (and/or insect sting, latex, etc.), I will need a new Emergency Allergy Action Plan to be filled out and signed by your physician by August 1st. I am happy to meet in person with you and can arrange a date and time if you would like to go over their allergy action plan together.

If your child will be needing a prescription medication administered while at school, I will need you to get the specified form filled out and signed by your physician. I must have a new one for each year. If your child has asthma and if there is any chance they may need an inhaler or nebulizer treatment throughout the school year, you must submit one of these forms to keep on file. There may be a day that they forget their inhaler, so I must have the form on file. I am happy to keep their inhaler in my office for administration as needed as long as I have new orders. 

The 3 forms I have discussed can all be found on the TVS Website above: K-12 Emergency Authorization and Permission to Treat, K-12 Severe Allergy Form, and K-12 Prescription Medication Form.

These documents may be dropped off in the Admin Office, Division Office, mailed, faxed, or scanned and e-mailed, whichever is easiest for you. Please submit by August 1, 2016. Students will not be allowed to participate in athletics or physical education class without the completed forms received by the school.

Fax: 817-321-0131
Mailed to: Trinity Valley School
Attn: Nurse Coats
7500 Dutch Branch Rd.
Fort Worth, TX 76132

In addition to submitting these documents, you will also receive information from TVS in regards to updating your contact info, emergency contacts, and medical information on RenWeb. It is extremely important that the information in RenWeb is accurate and updated throughout the school year.

Please feel free to email me with any questions or concerns you may have. I am also happy to meet with you in regards to your child for any medical conditions, allergies, medication administration instructions, etc.

I am looking forward to a great year! I hope you have a fun, safe, and healthy summer! Thank you,

Amy H. Coats, RN, BSN
TVS School Nurse
P) 817-321-0132
F) 817-321-0131 


We hope you are having a wonderful summer break! Please follow the instructions below for reviewing your information and the information on your child(ren) and updating if necessary.  Please complete this prior to August 1 to ensure all information is correct for the 2016-17 school year.  Thank you.

1. Go to
2. Click on "Parents"
3. Login with your username and password

4. Your children's schedules & activities are not available yet. When teacher and team pages are available in August, this information will be populated in the portal under Classes, Clubs & Athletics. This will be your portal for the 2015-16 school year.


To Update Your Contact and Medical Information
1. Click on the RenWeb button linked within the Parent Portal, then click on Web Forms (under the School Information section) in the left-hand column.
2. Click on the Family Demographic Form in the large panel on the right.
3. For each member of your family, you will find a form showing the demographic information we have on record. Additionally, you will find a medical form for each of your children enrolled at TVS and a pre-participation medical history for your children in grades 5-12. Please check each of these forms for accuracy and update any information as necessary.
            NOTE: By choosing Yes for Permission to Email Medical Report, the school nurse will notify you by email each time your child comes to the clinic.
4. Ensure that all Required Fields are completed and click Save at the bottom of the page.
Note: The medical forms are comprehensive and may take some time to review. Please read all the instructions for new and current students and note the links to downloadable documents which require a physician's signature. Also note that some information is listed as required.  Please take extra care to complete these fields.
If you have an email change or address change anytime during the school year, you can update your email address on the Family Demographic Form in RenWeb, accessible from the Parent Portal.
Parent Alert Emergency Notification System
Instructions for Parents

1. Click on the Family Demographics form in RenWeb.
2. Look under Custodial Parents. You will need to check this information for each custodial parent.
3. Check to make sure we have the correct phone numbers on record for you. Then scroll down to the bottom of the page and look under Preferences. There are four Parent Alert preferences as explained below.
Parent Alert Home Phone - click Yes if you want to receive alerts on this phone
Parent Alert Cell Phone - click Yes if you want to receive alerts on this phone
Parent Alert Work Phone - click Yes if you want to receive alerts on this phone
Parent Alert Do Not Want Text - click Yes if you DO NOT want to receive your alerts via text message on your cell phone.
4. Click Save to save your changes. You are now set to receive emergency notifications from the school. 



A great website for information about raising healthy children is  It is produced by the American Academy of Pediatricians and I encourage you to visit it.


New NIAID Animation Helps Explain Food Allergy
NIAID has developed a three-minute animation that shows how the immune system responds to a food allergen and what you should do to avoid potential exposures.

Did you know?

  • An estimated 15 million Americans have food allergies
  • Food allergies appear to be on the rise in all      industrialized countries
  • A food allergy reaction sends someone to the hospital      emergency department every three minutes

Check out the NIAID animation on YouTube.


Important Notices

Pertussis Information

Concussion Information

Video explaining how flu viruses attack

Here is a link to a helpful chart on the differences between a cold and a flu.

Head Lice 101

2015-2016 Texas Minimum State Vaccine Requirements for Students Grades K-12


Amy H. Coats, RN, BSN
School Nurse


Kim Bartell
Part-time School Nurse


Hannah Smitherman MD, FAAP
Pediatric Emergency Medicine
Cook Children's Physician Network
TVS Medical Director


817.321.0132 v  817.321.0131 f

Per Aspera Ad Astra   |   © 2012 Trinity Valley School   |   7500 Dutch Branch Road   |   Fort Worth, TX 76132   |   817.321.0100
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