We thank you in advance for your cooperation in helping us maintain a safe, healthy environment for all of our students. Please email the nurse to schedule a time (. Sample Non-Patient Specific Order for BinaxNow COVID-19 Testing(NYSCSH 12/20)This sample order can be used for schools implementing BinaxNow COVID-19 testing of students. Minnesota Department of Health, May 2016. Sample Field Trip Notification with Information for Parents on Insect Repellents (NYSCSH 6/2018). Its a great way to stay up to date about PANS/PANDAS and to see what events are available in your area. Sample School Letter to All Parents Sample WASSDA Policy Sample WASSDA Procedure . A parent or guardian must sign a consent form for the student to be seen, except in the areas of mental health and sexual health where minors can self-consent per state law. School health services contact information. As for infestation information, The Columbus City School offers information on lice and bedbug infestation. Teacher Introduction Letter to Parents Examples - We Are Teachers Before we wrap up the school year I wanted to send you off with a few tasks and dates in mind for the summer, especially for those of you with children who will play school . Blood Glucose / Insulin Log for Individual Students (NYSDOH Guide-Page 94). cic]i"F-?|JAD66Jmx~>-R)$tik:]oVP)FPWy?WGgqsA_Ks?1-RG/biiVrWv.\V:Bit9 .~W:%euk unJ&V.oIRC)L%> F}FIbW`4_hz1! Sample Emergency Care Flow Sheet (NYSCSH 12/16), Sample Emergency Care Flow Sheet for Staff (NYSCSH 9/17), Sample Faculty/Staff Emergency Contact Information (NYSCSH 5/16), Sample Individual Health Care Plan (NYSCSH 8/18). Author: Charlene Schexnayder 4v(w"Eyh?y,/X[#Y _c[ It is school policy to report when your child has when has been absent due to an illness. Letter Samples - (not from template or form, my own work) May 2019. Separate medication orders would be needed. Required Forms are indicated in the title. For more detailed information, see page 41 in Guidelines for Medication Management in Schools. It is important that these families know if their child has been exposed to strep or other illnesses. The HPV vaccine is given as a three-dose series over a six-month period to protect both females and males. Helping the Student with Diabetes Succeed Sample Diabetes Medical Management Plan, a sample template for an Individualized Health Care Plan, and sample Emergency Care Plans for Hypoglycemia and Hyperglycemia. School Checklist for Medications on Field Trips (NYSCSH 12/2016)Checklist of responsibilities regarding medication administration on field trips for the School Board/Administration, School Nurse/District Personnel, and Parent/Student. School Nurse To Do List. Sample Permission to Share Protected Health Information(HIPAA) (NYSCSH 8/12)Allows the parent to designate health care providers who may share information with designated school staff. We look forward to getting to know you and your child during the 2018-19 school year! @&>D8q!""u]WMvsE&H|+ There are teen vaccines that are not required for school but are recommended by the Center for Disease Control. Department of Public Health, you may find useful to be able to send to parents. No nebulizer treatments will be provided at school. Your childs personal information and identity will not be disclosed to anyone. school nurse. Parents should also ask about a second type of meningococcal vaccine (meningococcal B) that may be appropriate for their child between ages 16-18 years. wrap up the school year I wanted to send you off with a few tasks and dates in mind for the summer, especially for those of you with children who will play school sports. PDF LETTER TO PARENT/GUARDIAN - Pennsylvania Department of Health All SPS students can access mental and physical health services through our many school-based health centers. Our nurse cards are electronic this year! Instructions for School Nurses and School Medical Directors Related to Completion of the Required Health Examination Form (NYSCSH 1/21)Effective 1/31/2021. Older adolescents (age 13-18 years) who have not been vaccinated should receive their vaccines as soon as possible. PDF SECTION 5 SAMPLE FORMS - k12.wa.us They are available in many languages. Parent Interview Questionnaire for Seizure History (NYSCSH 6/12)Documents seizure history, medications, and current understanding of the condition, Seizure Observation / Recording Form Can be used to record seizures. Laws & Commissioner's Regulations by Content Area, Searchable Bills, Codes, Laws, Rules, and Regulations, NYSCSH e-Learning and Learning Management System (LMS), Athletics Forms | Letters | Notifications, Student-Athletes with Medical Conditions - Confidential List, Sample Recommended NYSED Interval Health History for Athletics. I begin my calendar in May because planning and preparation for the next school year begins long before August! School Nurse / Welcome Letter School Nursing Activities Annual Calendar from:https://www.esd105.org/site/handlers/filedownload.ashx?moduleinstanceid=2140&dataid=2364&FileName=2017%20School%20Nursing%20Activities_Annual_Calendar.pdf, Minnesota Department of Health, May 2016. They do not constitute a mandate nor imply liability should the school choose other options. in Charlotte. Sample Medical Exemption Approval Letter with Notification of Exclusion During Communicable Disease Outbreak (NYSCSH 9/19)This sample letter may be customized to inform parents/guardians that their child has been approved for a medical exemption and that in the case of an outbreak, their child would be excluded for the length of contagion. I am wanting to make parents aware and to remind their students to wash hands frequently, . Sample Students With Special Health Care Needs Record (NYSCSH 2/21)May be used to record students' health care concerns, medication, and emergency care plan status. PDF A Letter From the School Nurse Charlotte Isd If your child is lacking school-district required vaccines, I will contact you. Epinephrine District Staff Training Summary (NYSCSH 4/17)Provides a form to document staff trained in the administration of EAI. To be completed by the parent/guardian no earlier than 30 days before the start of the sport. JDRF School Advisory ToolkitContains information on Section 504, Legal Rights of the Child, common 504 Plan questions, and references. Please note that adolescents need a booster vaccine at age 16. It is vital for the School Nurse to foster communication between the entire school population about who and when someone has an infectious illness. DOC Letter to Parents: School Nurse - National Foundation for Infectious The calendar for the school at which I hope to work can be found here: https://www.columbusacademy.org/events There is no specific nursing calendar available here. I am a list maker and work well off lists. Appointments are required to drop off medication. This also provides us with the information on how to reach you if your child becomes ill or injured. This letter is an example he can follow. Sample Procedure for Unlicensed School Staff Responding to Severe Allergic Reactions (NYSCSH 4/17). As a final reminder, before your child can begin school with us we need these items. It is important that these families know if their child has been exposed to strep or other illnesses. Sample Dental Certificate (NYSED 3/18)This form aligns with health exam grade levels. Hypoglycemia Sample Emergency Care Plan (NYSCSH 10/17), Hyperglycemia Sample Emergency Care Plan (NYSCSH 10/17), Glucagon Training Documentation Form for School PersonnelDocuments understanding and skills attainment for staff voluntarily administering glucagon for students with patient-specific orders. Taking medications at school regularly or as needed? The Texas School Nurse. Monthly Medication Administration Record (Medicaid Compliant)(NYSCSH 2/2017)Records date, times, doses, exception codes, reactions, Medicaid-compliant signature boxes, and NPI number. Vision Screening Parent/Guardian Notification Results and Referral Form (NYSCSH 10/18) Note: Parents must be notified of both passing and failing vision results. Sample letters 1- Notification letter to parent for a school activity Dear parents, This is to inform you that the annual bake sale for charity will be held on Saturday, October 06, 20xx. Sample Generic Emergency Care Plan for Unlicensed School Personnel (NYSCSH 12/16)Information for unlicensed school staff to assist with emergency health issues. We want to welcome you as your School Nurse. Diastat/Seizure Preparedness Plan Links to Diastat website. This letter should be reviewed and approved by the School Medical Director prior to use. Your Child Was Seen In The Health Office With Symptoms of COVID-19(NYSCSH 1/22)Sample letter to send home with students who present with COVID-19 symptoms. Main Office: 206-252-3880, Northwest Coast Art by Andrea Wilbur-Sigo, Squaxin/Skokomish, See Registration and Course Catalog Information, Continuous School Improvement Plan and School Profile. The time to begin is nigh! 1. Before we. %PDF-1.7 2 0 obj Consider scheduling your childs check up for summer. I am requesting the care plan and medication authorizations to be signed by the Sept 8th, with some flexibility if needed. Sample Student Daily Visit Form (NYSCSH 1/18)Aids school health personnel in tracking follow-up on student visits to the health office. School sports, medication, and treatment forms are good for 1 year, so summer is a great time to complete them. Educational Service District 105, July 2016. Head Lice/Nits 4 . 1100 Ebenezer . Sample Recommended NYSED Interval Health History for Athletics (Fillable PDF NYSED)This form now includes questions related to the Dominic Murray Sudden Cardiac Arrest Act effective 7/1/22 and COVID-19. Vaccines are recommended to protect adolescents now and into adulthood. Chicken Pox; Conjunctivitis; Cover Letter to Send Home with Height Weight Screening; Fifth Disease; Provider & Parent/Guardian Permission for the Use of School-Provided Spacer/Valved Holding Chamber (NYSCSH 7/2020) Provides schools the opportunity to provide a backup spacer if the student's spacer is not available. Up to 20 percent of survivors will have serious long-term or permanent complications such as brain damage, kidney damage, deafness, or amputations. Dear Parents and Guardians, Congratulations! Please review the following and let us know if you have any questions. Communicable disease prevention, surveillance, notification, and reporting are important roles provided by the school health team. school day. These services are rendered for accidents and illnesses that occur during the school day. Why is it important that your child receive treatment? It is very important to read and follow the label directions carefully and specifically.