Health Forms:

Health Requirements by Grade

Certificate of Dental Screening

Certificate of Vision Screen

Religious Immunization Exemption

Medical Immunization Exemption

Emergency Health Forms:

Emergency Allergy Plan (take this to your student's healthcare provider)

Emergency Seizure Plan (take this to your student's healthcare provider)

Diabetes Medical Management Plan (take this to your student's healthcare provider)

Asthma Action Plan (take this to your student's healthcare provider)

Medication Forms:

Medication Administration Permission Form (Permission to be given medication while at school)

Authorization to Self Carry Prescribed Medication (take this to your student's healthcare provider)

Authorization to Self Carry Asthma/ Airway Constricting Medication (take this to your student's healthcare provider)

Diet Form:

Diet Modification Form (take this to your student's healthcare provider)

Illness Policy:

Student Illness/Injury at School: A student is sent home from school or should be kept home from school for any of the following reasons:

A. Fever- A fever is a temperature over 100.4 degrees. A student should remain home until fever-free for 24 hours without the use of fever reducing medications such as Tylenol.

B. Vomiting and/or diarrhea- A student may return when “normal” after a minimum of 24 hours.

C. Body rash

D. Abnormal eye drainage- pink eye appears as redness of the conjunctiva (lining of eye/ eyelid) with or without pus drainage from eye and/ or swelling. Students should not return to school until they have been examined and released by a healthcare provider.

E. Severe cough

If a student becomes ill, the school nurse or designee calls the student’s parent/guardian or emergency contact. (Please make sure all emergency contact information is up to date) At that point a decision is be made to: 1. Allow the student to rest at school and return to class in a reasonable amount of time. 2. Make arrangements for the student to be picked up and taken home within one hour of being notified.

Absences from Physical Education/Extra-Curricular Activities/Recess: 

• If your student is unable to participate fully in physical activities, recess and/or extra-curricular activities, then a healthcare provider’s note is required. A copy of the note should be given to the school nurse.  The school nurse will provide copies to staff that need to know.

• If your child has had any type of surgery or has any kind of device such as a boot, brace, crutches, splint, wheelchair, or medical device, etc… a healthcare provider’s note is required prior to the student returning to school.

• It is assumed that if you are participating in out of school physical activity, then you are required to also participate in PE class.

   
  *Note: Students who were seen by a healthcare provider for illness, surgery, injury, etc. must have appropriate clearance, in writing, from that healthcare provider before they will be allowed to return to activities.