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Health Office Form

Welcome to Manchester Regional High School's

Virtual Nurse's Office

IR school nurse

Ms. Irique Robinson

Passaic County Manchester Regional High School students, staff, and parents have the oppurtunity to virtually meet the school nurse Ms. Irique Robinson for advice on personal medical-related questions or concerns during school hours:

Monday - Friday 8:00am - 3:00pm.

External links

COVID-19 Mobile Testing Site November

Please fill out the following contact information to schedule an apointment with the MRHS Health office.

Once the form is submited you will recieved an email from "[email protected]" to book your Virtual Health Office Appointment.

(Fields with * are required)

Student ID Number*

Answer Required

First Name*

Answer Required

Last Name*

Answer Required

Manchester Email Address

Answer Required

Parent or Guardian Email Address

Answer Required

Mobile Phone*

Number Required

Home Phone

Number Required

Work Phone

Number Required

Preferred Method of Contact*

Answer Required

Student Email

Parent or Guardian Email

Mobile Phone

Home Phone

Work Phone

Briefly describe your reason for the appointment: *

Answer Required

Please Upload any Necessary Documents. (Keep?)

Answer Required

Choose a file or drag it here.

Confirmation Email

Confirmation Email *

Email Required