Health Services

The Nurse’s Office is open Monday through Friday from 7:30 am to 6:00 pm and Saturday from 8:00 am to 12:00 pm. It is staffed by four full-time nurses who provide first aid, assess illnesses and injuries, administer prescribed medications, and treat minor medical concerns.

When a student visits the Nurse’s Office, a nurse will assess the student’s symptoms or injury, provide appropriate care, and document the visit. Parents or guardians will receive an email notifying them of the visit.

For minor cuts, scrapes, bruises, and other routine concerns, parents will be notified by email only. For more serious injuries, persistent symptoms, or situations requiring additional medical attention, the nursing staff will contact parents or guardians by phone using the emergency contact information on file.

To ensure we can reach you when necessary, please keep your emergency contact information up to date with your divisional office.

Deciding whether to keep your child home from school is not always easy. While regular attendance is important, students who are ill should remain at home under the care of a responsible adult until they have recovered. Keeping sick children at home also helps protect the broader school community's health.

Graded recommends keeping your child at home if they exhibit any of the following symptoms:

• Fever of 100°F (37.8°C) or higher
• Vomiting
• Diarrhea
• Rash, particularly when accompanied by a fever
• Moderate to severe flu-like symptoms
• Persistent or severe cough
• Severe sore throat or white spots on the throat
• Chickenpox
• Conjunctivitis (pink eye)
• Signs or symptoms of an acute illness
• A serious accident or injury
• Asthma symptoms that do not respond to medication
• Head lice
• Any other contagious or infectious illness

This list is not exhaustive. If your child is unwell, we encourage you to consult your healthcare provider for medical advice.

Students should be symptom-free for at least 24 hours before returning to school unless otherwise directed by their physician.

If the nursing staff suspects that a student has a contagious illness, parents or guardians will be contacted and asked to pick up their child. Before returning to school, the student must be evaluated by a physician and provide an atestado médico (medical certificate) indicating the diagnosis, the recommended period away from school, and the corresponding CID (International Classification of Diseases – ICD) code.

Conjunctivitis
If your child is diagnosed with conjunctivitis, they must present a doctor’s note before returning to school. The note should be given to the school nurse upon the student’s arrival. Because conjunctivitis is highly contagious, we strongly recommend that all household members be monitored for symptoms and seek medical evaluation and treatment if necessary.

For additional information and recommendations, please refer to: Health Services Recommendations - Conjunctivitis

Head Lice
According to the American Academy of Pediatrics, “There is a lack of evidence showing that routine class or school-wide screening reduces lice infestation rates” (Frankowski, 2010). Therefore, Graded does not conduct routine classroom or school-wide head lice screenings. Parents are encouraged to check their children periodically for head lice. If live lice are identified on a student during the school day, parents or guardians will be contacted and asked to pick up their child. Families will receive information about head lice and the recommended treatment. After treatment at home, the student may return to school the following day and will be re-examined by the school nurse before returning to class. If live lice are still present, parents or guardians will be contacted again. All household members should also be checked and treated, if necessary, to help prevent reinfestation.

For additional information and recommendations, please refer to: Health Services Recommendations - Head Lice

Graded’s COVID-19 protocols are guided by the Joint Ordinance of the Municipal Health Secretariat (SMS) and the Municipal Education Secretariat (SME) No. 377 of June 20, 2022, including Annex I (Portaria nº 377/2022), as well as current CDC guidelines.

Based on these guidelines, Graded follows the protocols below:

• If you have COVID-19, you can spread the virus to others. To help prevent transmission, isolate yourself, wear a high-quality mask when around others, and avoid close contact with individuals who are at high risk of severe illness.
• If you test positive for COVID-19, it is recommended that you isolate for at least five days, including from members of your household whenever possible. If you must be around others at home or in public, wear a high-quality mask for seven days.
• If two or more students in a Lower School classroom test positive for COVID-19, all students and teachers in that classroom must wear masks indoors for 14 days. Masks are not required outdoors.
• Isolation may end five days after symptom onset (with the day symptoms begin considered day zero) if both of the following conditions are met:
  • You have been fever-free for at least 24 hours without the use of fever-reducing medication; and
  • Your other symptoms are improving.

  Alternatively, isolation may end if a negative COVID-19 test result is submitted to the Nurse’s Office.

• Students who remain asymptomatic after close contact with a person who has tested positive for COVID-19—including a household member—may continue to attend school.
• If you still have a fever on day five, continue isolating through day seven. If your fever persists on day seven, continue isolating through day ten.
• Graded accepts COVID-19 antigen tests administered at a pharmacy and laboratory-based PCR tests. The school no longer partners with Mendelics for COVID-19 testing.

If you have any questions concerning the new protocols, please email Head Nurse Rita Lupo at rita.lupo@graded.br.

Health Information Submission and Update Form
To help ensure the health and safety of every student, all families are required to complete the Health Information Submission and Update Form in PowerSchool for each child every school year. The information you provide enables the Nurse’s Office to respond quickly and appropriately to illnesses, injuries, or medical emergencies at school and during school-sponsored activities and trips.

Please follow the instructions in this tutorial to complete the form.

As part of the annual update, you will be asked to:

• Upload your child’s identification documents (RG/RNM and passport)
• Provide your child’s primary physician and health insurance information
• Submit your child’s updated Vaccination Declaration (DVA). If you are unable to obtain the DVA, please upload your child’s current vaccination record instead. A list of required immunizations is available here.
• Update information regarding allergies, medications, and other health conditions

According to the Federal Nursing Council of Brazil (COFEN), school nurses may administer basic over-the-counter medications (such as pain relievers) only if a parent or guardian has completed the Health Information Submission and Update Form.

Additional Medical Forms
Students with diabetes or severe allergies must also submit the appropriate medical management form each school year. These forms must be completed by a physician licensed in Brazil and submitted to the Nurse’s Office before the first day of school.

Please use the appropriate form below:

• Diabetes Medical Management Plan (DMMP) Form — for students with diabetes
• Food Allergy & Anaphylaxis Emergency Care Plan — for students with severe food allergies