Nicole R. Wesig, RN
Important forms are attached at the bottom of this window:
Medications: The following guidelines must be adhered to for the safety of all students.
- All medications prescription and over-the counter must be brought to the clinic by the parent and the medication must be in its original container.
- Administration of Medication form must be accompanied with each medication.
- No student should be carrying any medications in the school building.
- All medications in the clinic must be picked up by the parent at the end of the school year. Any medications left in the clinic after that time will be disposed.
Health Management Plans: Students that have medical conditions that require monitoring or medications such as asthma, diabetes, heart conditions, severe allergies, seizures, etc. will need a health management plan completed by the parent/guardian. Allergy, Asthma, and Diabetic Plans require a physician’s signature and require more than one form to be completed.
Check-Out Policy: The clinic is available for illnesses and injuries that occur during school hours. If a student is too ill to remain at school a parent/guardian will be contacted to pick the student up. The clinic must receive verbal permission from a parent before releasing any student from school that is capable of driving home while sick or injured. The clinic does not checkout students for doctor appointments.
Parent Authorization for Auto-Injectable ephinephrine 2017 (This form needs to be completed and returned to the clinic for any student that may require an epinephrine injection at school.)
Hypodermic Injection Form (This form needs to be completed and returned to the clinic along with a Glucagon injection.)
Medication Administration Request(All medications administered at school require this form)
Seizure Management Plan