Schools must maintain up-to-date information on any student who has a medical condition that may require emergency care at school.
|
|
- Curtis Watson
- 8 years ago
- Views:
Transcription
1 POLICY NO MEDICAL ALERT AND ADMINISTERING MEDICATION TO STUDENTS POLICY Schools must maintain up-to-date information on any student who has a medical condition that may require emergency care at school. Students who are on medication which they have to take during school hours should be treated with the utmost care. In order to avoid any confusion over what is or is not required, the following regulations for the administration of medication should be STRICTLY adhered to. ADOPTED: December 8, 1998, Amended: Nov. 13, 2007 Page 1 of 6
2 POLICY NO MEDICAL ALERT AND ADMINISTERING MEDICATION TO STUDENTS REGULATIONS 1. Schools will ensure that they implement a system to obtain current information on any student who has a medical condition that may require emergency care at school. The Medical Alert System form will be used. 1.1 Such information will be updated annually. 2. The Medical Alert System should ensure that staff are aware of the student s condition and are familiar with the appropriate action to take if required. 3. If it is required that a student take medication during school hours the school should ensure that the Request for Administration of Medication at School form has been completed. 4. Teachers shall not be called on to administer medication on a regular or predictable basis. Exceptional circumstances will be discussed with the Association. 5. In an emergency situation, an employee of the Board is expected to act as a responsible parent might in the administration of medication in any form to a child. ADOPTED: December 8, 1998, Amended: Nov. 13, 2007 Page 2 of 6
3 MEDICAL ALERT SYSTEM Student Name: Date of Birth: Y / M / D Personal Health Care No. (from Care Card) Parents Names: Telephone: Home: Mother s Work: Father s Work: Other Name and Phone Number: Name of Physician: Physician s Phone: Indicate what medical condition this student has that may require emergency care at school: Describe the potential problem (include symptoms that might be observed): Continued on reverse... THIS FORM MUST BE COMPLETED AT THE START OF EACH SCHOOL YEAR Please check the signature / date at the end of this form to ensure it is current Destroy all outdated forms ADOPTED: December 8, 1998, Amended: Nov. 13, 2007 Page 3 of 6
4 Describe the necessary action or intervention to appropriately treat this medical condition: Step 1: Step 2: Step 3: Step 4: Step 5: Is medication needed? YES NO If yes, what medication (circle one) Parents must complete a REQUEST FOR ADMINISTRATION OF MEDICATION FORM which is also available from your school. Parents need to ensure that this medication does not go past its expiry date. It is the obligation of the parents to keep a current supply of any required medication at the school. If training is required to administer the medication such as with an EpiPen (auto injector) please identify who will do the training and the date training is completed. Please be aware that parents are most often the trainer. If assistance from the Public Health Nurse is required please call the Health Unit to make arrangements. Training on: Name of Trainer: People Trained: Print Name Signature Date Print Name Signature Date Print Name Signature Date Signature of Parent Date THIS FORM MUST BE COMPLETED AT THE START OF EACH SCHOOL YEAR ADOPTED: December 8, 1998, Amended: Nov. 13, 2007 Page 4 of 6
5 REQUEST FOR ADMINISTRATION OF MEDICATION AT SCHOOL A. To be completed by parent or guardian. Name Birth Date (Y/M/D) Parent or Guardian Home Phone Business Phone Physician Phone B. To be completed by prescribing physician LIST CONDITION(S) WHICH MAKE MEDICATION NECESSARY NAME OF MEDICATION DOSAGE DIRECTIONS FOR USE Additional Comments (possible reactions, consequences of missing medication, etc.) Physician s Signature / Date C. To be completed by parent/guardian I request the school give medication as prescribed in the upper section of this form to my child whose name is recorded below. Name of Child I will notify the school promptly of any changes in medications ordered. Date Signature of Parent/Guardian Continued on reverse... ADOPTED: December 8, 1998, Amended: Nov. 13, 2007 Page 5 of 6
6 D. Each school staff member who is responsible for the administration or supervision of the medication must review the information on this card then date and sign below. Date Signature Comments ADOPTED: December 8, 1998, Amended: Nov. 13, 2007 Page 6 of 6
Crosspoint Clubhouse
Crosspoint Clubhouse To the Parents/Guardians of The health and safety of our students is a priority for our school. Because your child has a life threatening allergy that may require the use of an Epinephrine
More informationIndividualized Healthcare Plan (IHP) Core Form
Individualized Healthcare Plan (IHP) Core Form An Individualized Healthcare Plan (IHP) should be developed by the parents/guardian, school nurse, student and other pertinent school officials. This plan
More informationPlum Borough School District Nursing Services Department
Information Regarding the Student with an Allergy Student s Name Grade Homeroom Date Physician s Name Physician s Phone # Type of Allergy (Food, Bee, Wasp, Latex, Other: Specify): Type of Reaction: For
More informationWyckoff Administration Policy on Epinephrine Nurse, Student and or Delegate
Wyckoff Administration Policy on Epinephrine Nurse, Student and or Delegate It is the policy of this school to apply New Jersey Law N.J.S.A. 18A: 40-12.3-12.6 in the following way: The school will provide
More informationPlease email: tchin@sbnature2.org for more details.
Medication Protocol: All medications (both over-the-counter and prescribed) must be cleared by the camper s guardian (additionally all prescribed meds must be cleared by a Physician) by filling out the
More informationSSS01 Health Management and Medication Policy
An Australian tradition since 1883 Cricos Provider number 00197D SSS01 Health Management and Medication Policy PURPOSE This policy is established to ensure Stott s Colleges meets its commitments to maintaining
More informationADMINISTRATION OF MEDICATIONS POLICY
Policy 6.007. ADMINISTRATION OF MEDICATIONS POLICY It is the policy of Cooperative Educational Services (C.E.S.) that students who require any medications to be administered during school hours, including
More informationAdministrative Procedure 5139-APPENDIX A Photo here Individual Health Care Plan-Allergy/Asthma
Administrative Procedure 5139-APPENDIX A Photo here Individual Health Care Plan-Allergy/Asthma Student: Student s weight: : Teacher: Grade: School: Home phone: Medical Diagnosis & Brief Medical History:
More informationAllergy Action Plan For the 2015-2016 School Year
Allergy Action Plan Student s Name: DOB Grade ALLERGY TO: Asthmatic: Yes*[ ] No [ ] *Higher risk for severe reaction! STEP 1 TREATMENT Symptoms: Give checked medication To be determined by physician authorizing
More informationSCHOOL DISTRICT #43 (COQUITLAM) MEDICAL ALERT FORMS FORM(S) MUST BE COMPLETED AT THE START OF EACH SCHOOL YEAR
SCHOOL DISTRICT #43 (COQUITLAM) MEDICAL ALERT FORMS FORM(S) MUST BE COMPLETED AT THE START OF EACH SCHOOL YEAR Please read instructions below carefully. Feel free to contact your school if you need any
More informationPlease put above in a plastic Ziploc bag with your child s name on it.
Dear Parent(s), You have noted your child has medications related to an allergic reaction. The Stamford Museum & Nature Center s requirements for noted medications are as follows: Epi-pen requirements
More informationADMINISTRATIVE PROCEDURE. Request for School Assistance in Health Care (Administration of Prescribed Medication)
ADMINISTRATIVE PROCEDURE SO102 Request for School Assistance in Health Care (Administration of Prescribed Medication) Board Received: Review Date: February 2014 Accountability: 1. Frequency of Reports
More informationOFFICE OF CATHOLIC SCHOOLS ARCHDIOCESE OF CHICAGO
OFFICE OF CATHOLIC SCHOOLS ARCHDIOCESE OF CHICAGO SCHOOL MEDICATION PROCEDURES Parents/guardians have the primary respomibility for (he adminislration of medical ion to their children. The administration
More informationLindenwold Board File Code # 5141.21 Of Education Page 1 of 7
Of Education Page 1 of 7 The Board of Education disclaims any and all responsibility for the diagnosis and treatment of the illness be contingent upon the timely administration of medication duly prescribed
More informationSCHOOL DISTRICT #43 (COQUITLAM) MEDICAL ALERT FORMS FORM(S) MUST BE COMPLETED AT THE START OF EACH SCHOOL YEAR
SCHOOL DISTRICT #43 (COQUITLAM) MEDICAL ALERT FORMS FORM(S) MUST BE COMPLETED AT THE START OF EACH SCHOOL YEAR Please read instructions below carefully. Feel free to contact your school if you need any
More informationAdministration of Oral Prescription Medication Directive
Administration of Oral Prescription Medication Directive Directive for Policy 4.2 Medical/Health Supports Projected Review Date: Nov. 2018 RATIONALE: Hamilton-Wentworth District School Board is committed
More informationOther Forms from Seattle Public School District
SEATTLE PUBLIC SCHOOLS Other Forms from Seattle Public School District Medical & Other Forms Privacy Rights Student Survey Form to Identify Disabled Students (504-2) Authorization for Medications to be
More informationIndian Hill Exempted Village School District Auto-injector (Epi-pen) Self-carry Plan
Indian Hill Exempted Village School District Auto-injector (Epi-pen) Self-carry Plan To provide the best care for our students, two options are available for administration of an auto-injector (Epi-pen)
More informationPERRYSBURG EXEMPTED VILLAGE SCHOOL DISTRICT
PERRYSBURG EXEMPTED VILLAGE SCHOOL DISTRICT MEDICATION IN SCHOOL 5330 F1/page 1 of 5 Before the student will be permitted to take medication during school hours or to use a self-administer medication and
More informationCrossroads Church. Health Information and EpiPen Administration Policies and Procedures
Crossroads Church Health Information and EpiPen Administration Policies and Procedures Overview: Crossroads Children s Ministry is dedicated to bringing church and family together for a child s spiritual
More informationADMINISTRATION OF HEALTH CARE PROCEDURES
1 of 1 POLICY G.1.M ADMINISTRATION OF HEALTH CARE PROCEDURES Frontier School Division is committed to providing educational services for all students. The Division acknowledges that some students may require
More informationMCLEAN BIBLE CHURCH, LOUDOUN CAMPUS - KID S QUEST HEALTH INFORMATION AND EPIPEN ADMINISTRATION POLICIES AND PROCEDURES
MCLEAN BIBLE CHURCH, LOUDOUN CAMPUS - KID S QUEST HEALTH INFORMATION AND EPIPEN ADMINISTRATION POLICIES AND PROCEDURES Overview: Kid s Quest is dedicated to bringing church and family together for a child's
More informationRutland Community School Tel: 250-765-4052 REGISTRATION FORM
Rutland Community School Tel: 250-765-4052 620 Webster Road Kelowna, BC V1X 4V5 Fax: 250-870-5066 REGISTRATION FORM General Information Child Name Middle Name Nick Name Weight Height Sex (circle) M F of
More informationStudents. Burr Ridge Community Consolidated School District #180 Policy Manual 7:270. Administering Medicines to Students 1
Burr Ridge Community Consolidated School District #180 Policy Manual 7:270 Administering Medicines to Students 1 Students Students should not take medication during school hours or during school-related
More informationRegulation 757-3 STUDENTS November 13, 2013 STUDENTS. Student Health Services and Requirements
STUDENTS November 13, 2013 STUDENTS Student Health Services and Requirements Guidelines for School Staff/Child Care Contractor (CCC) to Carry Out Health Treatment Procedure and/or Emergency Treatment Procedures
More informationDefinitions For the purpose of this policy, the following definitions shall apply:
5141.21 Administration of Student Medications in the Schools A licensed school nurse, or in the absence of such nurse, qualified personnel for schools may administer medication to students in the school
More informationChicago Public Schools Policy Manual
Chicago Public Schools Policy Manual Title: ADMINISTRATION OF MEDICATION POLICY Section: 704.2 Board Report: 12-0125-PO2 Date Adopted: January 25, 2012 THE CHIEF EXECUTIVE OFFICER RECOMMENDS: That the
More informationTitle POLICY NO. 210.1 POSSESSION/USE OF ASTHMA INHALERS
Policy No. 210.1 KEYSTONE OAKS SCHOOL DISTRICT Section PUPILS Policy Guide Title POSSESSION/USE OF ASTHMA INHALERS Adopted DECEMBER 9, 2009 Revised POLICY NO. 210.1 1. Authority The Board shall permit
More informationFerry Beach Ecology School Medical Management Plan -- Student with Chronic Illness or Severe Allergy
Medical Management Plan -- Student with Chronic Illness or Severe Allergy Students at Ferry Beach Ecology School (FBES) have full access to health services by a school nurse. The FBES nurse will identify
More informationThis technical advisory is intended to help clarify issues related to delegation of medications during the school day.
This technical advisory is intended to help clarify issues related to delegation of medications during the school day. Actual Text - Ed 311.02 Medication During School Day (a) For the purpose of this rule
More information5141.21(a) Students. Administering Medication
5141.21(a) Administering Medication The purpose of this policy is for the Board of Education (Board) to determine who shall administer medications in a school and the circumstances under which self-administration
More informationHEALTH SERVICES PROGRAM
HEALTH SERVICES PROGRAM The Board of Education will provide for the health and physical well being of students through the establishment of a district wide student Health Services Program in the school
More informationStudents 4000 OP 4.600. Medical Alert
Students 4000 OP 4.600 Medical Alert BACKGROUND There are students in school who may require emergency care interventions by school staff. These students are commonly referred to as students with a medical
More informationChicago Public Schools Policy Manual
Chicago Public Schools Policy Manual Title: ADMINISTRATION OF MEDICATION DURING SCHOOL HOURS Section: 704.2 Board Report: 06-0927-PO1 Date Adopted: September 27, 2006 Policy: The Chief Executive Officer
More informationMedication Administration and Delegation in Massachusetts Schools Training Manual
Medication Administration and Delegation in Massachusetts Schools Training Manual Massachusetts Department of Public Health School Health Unit GUIDELINES FOR REVIEWING AND APPROVING APPLICATIONS TO REGISTER
More informationPsychiatric Consultants of Atlanta, P.C. 1835 Savoy Drive Suite 101 Atlanta, Georgia 30341 Phone: 770-234-0981 Fax: 770-234-0252 www.pcatl.
Psychiatric Consultants of Atlanta, P.C. 1835 Savoy Drive Suite 101 Atlanta, Georgia 30341 Phone: 770-234-0981 Fax: 770-234-0252 www.pcatl.com CONTACT INFORMATION AND PERSONAL DATA Name: Date of Birth:
More informationADMINISTRATION OF MEDICATION
SOUTH LYON COMMUITY SCHOOLS 5330/page 1 of 6 ADMINISTRATION OF MEDICATION Definitions Medication includes both prescription and non-prescription medications including those taken by mouth, inhaler, injection,
More informationSTATE OF CONNECTICUT REGULATION of State Department of Education Name of Agency
Page 1 of 12 STATE OF CONNECTICUT REGULATION of State Department of Education Name of Agency Concerning Subject Matter of Regulations Administration of Medication by School Personnel and Administration
More information5141.21(a) Policy. Students. Draft Revised Policy. Administering Medication
5141.21(a) Policy Draft Revised Policy Administering Medication The purpose of this policy is for the Board of Education (Board) to determine who shall administer medications in a school and the circumstances
More informationMedication Administration and Delegation in Massachusetts Schools Presented by
Medication Administration and Delegation in Massachusetts Schools Presented by Massachusetts Department of Public Health in collaboration with the Northeastern University School Health Institute Massachusetts
More information105 CMR: DEPARTMENT OF PUBLIC HEALTH 105 CMR 210.000: THE ADMINISTRATION OF PRESCRIPTION MEDICATIONS IN PUBLIC AND PRIVATE SCHOOLS
105 CMR 210.000: THE ADMINISTRATION OF PRESCRIPTION MEDICATIONS IN PUBLIC AND PRIVATE SCHOOLS Section 210.001: Purpose 210.002: Definitions 210.003: Policies Governing the Administration of Prescription
More informationRULE. The Administration of Medication in Louisiana Public Schools
RULE The Administration of Medication in Louisiana Public Schools Developed in 1994 by The Louisiana State Board of Elementary and Secondary Education and The Louisiana State Board of Nursing Amendments
More informationOhio Department of Health Authorization for Student Possession and Use of an Epinephrine Autoinjector
Ohio Department of Health uthorization for Student Possession and Use of an Epinephrine utoinjector In accordance with ORC 3313.718/3313.141 completed form must be provided to the school principal and/or
More informationStudent & Health Information for Bates College Off-Campus Short Term Courses
Student & Health Information for Bates College Off-Campus Short Term Courses 1. Name Program/Course Bates ID # Email Cell phone: Home Address: Date of Birth Nationality If course is going abroad, attach
More informationRecommended guidelines for. schools
Recommended guidelines for medication administration in schools Objective At the end of the session the nurses will be aware of the HAAD standards and roles and responsibilities of a nurse in medication
More informationDate Submitted: July 20, 2000 Date Reviewed: May 31, 2005 January 17, 2006 March 17, 2009 Subject: Administration of Medication
POLICY SOMERSET COUNTY BOARD OF EDUCATION 1. PURPOSE Date Submitted: July 20, 2000 Date Reviewed: May 31, 2005 January 17, 2006 March 17, 2009 Subject: Administration of Medication Number: 600-32 Date
More informationEpiPen Administration
EpiPen Administration You may feel like this now But after this program, you ll feel like this Your objectives are: Accurately recognize student-specific warning signs of allergic emergency Accurately
More informationROLE OF THE PARENT/LEGAL GUARDIAN IN THE ADMINISTRATION OF MEDICATION AT SCHOOL
ROLE OF THE PARENT/LEGAL GUARDIAN IN THE ADMINISTRATION OF MEDICATION AT SCHOOL The parent/legal guardian who wishes medication to be administered at school to his/her child has the following responsibilities:
More informationSection Four: Students 436R MANAGING STUDENTS WITH MEDICAL ALERT/ANAPHYLAXIS CONDITIONS (REGULATIONS)
436R MANAGING STUDENTS WITH MEDICAL ALERT/ANAPHYLAXIS CONDITIONS (REGULATIONS) ROLES: The Parents/Guardians will: NOTE: In the case of senior secondary students, some of the parent/guardian role may be
More informationCSO Broken Bay 2006 Guidelines for Administering Medication in Schools
GUIDELINES FOR ADMINISTERING MEDICATION IN SCHOOLS CSO Broken Bay 2006 Guidelines for Administering Medication in Schools page 1 CONTENTS Administering Medication...3 Privacy...3 Routines...3 Reminders...4
More informationIf#Your#Child#Requires#Medication#While#at#Camp:#
If#Your#Child#Requires#Medication#While#at#Camp:# All prescription and nonprescription medication given in child care, camp or school settingsrequireawritten#authorizationfromyourhealthcareprovider,aswellasparent
More informationTelephone: Home Work Cell E-mail Address Father/Guardian: Address:
SAMPLE Diabetes Medical Management Plan/Individualized Healthcare Plan Part A: Contact Information must be completed by the parent/guardian. Part B: Diabetes Medical Management Plan (DMMP) must be completed
More informationAdministration of Medication
Department of Corporate Services Human Resources Managers to Manage Administration of Medication Guidance on supporting children with Medical needs in schools including Special School Settings Date of
More informationEarly Learning Centre and Out of School Hours Care Enrolment Form
Early Learning Centre and Out of School Hours Care Enrolment Form INFORMATION ABOUT THE CHILD Family name: Given names: Usually called: Date of Birth: Male q Female q Home address: Email address:: Language(s)
More informationAdministration of Medications Policy
5141.21 Administration of Medications Policy Statement of Purpose The policy and procedures for the administration of medication in schools are written in accordance with Connecticut Education Laws. Families
More informationADMINISTRATION OF MEDICATION BY SCHOOL PERSONNEL
TRUMBULL BOARD OF EDUCATION SECTION: 5000 BOARD OF EDUCATION CATEGORY: Students POLICY MANUAL POLICY CODE: 5141.21-Administration of Medication by School Personnel Policy ADMINISTRATION OF MEDICATION BY
More informationADMINISTRATION OF PRESCRIPTION MEDICATIONS IN SCHOOLS OBJECTIVES. Purpose of Regulations 105 CMR 210.000. Diane M. Gorak, RN, MEd
ADMINISTRATION OF PRESCRIPTION MEDICATIONS IN MASSACHUSETTS SCHOOLS Diane M. Gorak, RN, MEd OBJECTIVES Review Massachusetts Regulations Recognize Challenges Ensure Safe Delivery of Prescription Medications
More informationDiabetes Health Care Plan
The Public Schools of Brookline School Health Services of Plan: Diabetes Health Care Plan To be completed by the student s health care team and parents/guardian. Plan will be kept with the school nurse
More informationSPRINGFIELD PUBLIC SCHOOLS COMPREHENSIVE SCHOOL HEALTH PROGRAM Administration of Medication in Springfield Public Schools
SPRINGFIELD PUBLIC SCHOOLS COMPREHENSIVE SCHOOL HEALTH PROGRAM Administration of Medication in Springfield Public Schools LAW: Massachusetts General Law, Chapter 94 C These medical guidelines are established
More informationMEDICATION ADMINISTRATION TO STUDENTS PROCEDURES
Policies of the Board of Education Series 400: Students MEDICATION ADMINISTRATION TO STUDENTS PROCEDURES I. Training of Designee 453.4-Rule The health care professional, in collaboration with a school
More informationDIABETES FOR STUDENT SELF-MANAGEMENT OF HEALTH CONDITION STEP 1 PARENT OR GUARDIAN REQUEST TO ALLOW STUDENT TO SELF-MANAGE HEALTH CONDITION AT SCHOOL
DIABETES DIABETES FOR STUDENT SELF-MANAGEMENT OF HEALTH CONDITION STEP 1 PARENT OR GUARDIAN REQUEST TO ALLOW STUDENT TO SELF-MANAGE HEALTH CONDITION AT SCHOOL ( the Student ) has diabetes. I/we hereby
More informationMedication Administration Guidelines for Child Care Programs
Medication Administration Guidelines for Child Care Programs A. Medication Administration Policy The child care program will administer medication to children for whom a plan has been made and approved
More informationOhio Department of Health Authorization for Student Possession and Use of an Asthma Inhaler In accordance with ORC 3313.716/3313.
Ohio Department of Health uthorization for Student Possession and Use of an sthma Inhaler In accordance with ORC 3313.716/3313.14 completed form must be provided to the school principal and/or nurse before
More informationADMINISTRATION OF MEDICATION TO STUDENTS POLICY
CODE: C.009 Program CONTENTS ADMINISTRATION OF MEDICATION TO STUDENTS 1.0 PRINCIPLES 2.0 POLICY FRAMEWORK 3.0 AUTHORIZATION POLICY 1.0 PRINCIPLES 1.1 The primary responsibility for administering medication
More informationADMINISTRATION OF MEDICATION BY AUTHORIZED POLK COUNTY SCHOOL PERSONNEL
ADMINISTRATION OF MEDICATION BY AUTHORIZED POLK COUNTY SCHOOL PERSONNEL 1. Principals/Directors of each school are required to designate a minimum of three staff members as Health Contacts who will be
More informationParent s Consent Form for a School-Aged or Young Child
Parent s Consent Form for a School-Aged or Young Child The Child Employment Act 2006 and the Child Employment Regulation 2006 define specific restrictions on work that can be performed by school-aged or
More informationAdministration of Medicines and Healthcare Needs in Schools
Administration of Medicines and Healthcare Needs in Schools The administration of medicines by staff remains a voluntary activity. Employees who volunteer to assist with any form of medical procedure are
More informationGlenburnie Summer Camp 2015 Registration Please read and sign where necessary.
Glenburnie Summer Camp 2015 Registration Please read and sign where necessary. Registration Information: Please complete one form per child by providing all the necessary information, checking off your
More informationYouth Camp Civic Center
Youth Camp Civic Center Household ID # Please circle the session(s) that your child(ren) will attend Session One June 8- June 12 Session Two June 15 June 19 Session Three June 22 June 26 Session Four June
More informationCharlton Christian College Council
Charlton Christian College Medication Guidelines Policy and Procedures Prepared by Number of pages Susan Skuthorpe Six Date revised July 2011 Date for review November 2012 Monitored by Review by Charlton
More informationTYPE 2 DIABETES PROCEDURES AND FORMS ELEMENTARY SECONDARY SCHOOL ADMINISTRATOR
TYPE 2 DIABETES PROCEDURES AND FORMS ELEMENTARY SECONDARY SCHOOL ADMINISTRATOR 2013 SCHOOL ADMINISTRATOR TYPE 2 DIABETES PROCEDURES and FORMS: Parent/guardian informs school administrator child/youth has
More informationSection 504 Plan (pg 1 of 8)
Section 504 Plan (pg 1 of 8) of Birth School Today s Section 504 Plan for: Disability: Diabetes School Year: Grade: Homeroom Teacher: Bus Number: Background Objectives The student has type diabetes. Diabetes
More informationJohns Creek Montessori School Of Georgia
ENROLLMENT FORM Pre-Primary (Toddler) Primary Half Day Full Day All Day Start : Child s Information: Child s Name Street Address Nickname of Birth Subdivision Name Primary Language Spoken Parent/Guardian
More informationAdministration of Medication in Schools
Administration of Medication in Schools Two provisions of the Illinois School Code (hereinafter School Code ) discuss the administration of medication in public school districts. The first is Section 10-22.21b,
More information4. Emergency medical treatment due to injury or physical illness. 5. Hospitalization (Medical) due to injury or physical illness
MCCMH MCO Policy 9-321 CONSUMER, INCIDENT, ACCIDENT, ILLNESS, DEATH, OR ARREST REPORT MONITORING Date: 7/02/13 receive and review all Consumer Incident, Accident, Illness, Death or Arrest Reports for violations
More informationYouth Programs Registration Form Summer of Service (SOS) 2015
Youth Programs Registration Form Summer of Service (SOS) 2015 Participant s Information PHONE GENDER: FEMALE OF BIRTH SCHOOL GRADE IN FALL 2015 MALE ETHNIC BACKGROUND AFRICAN ASIAN INDIAN LATINO NATIVE
More informationHow To Treat A Concussion
Medical management of sports-related concussion continues to evolve. Recently, there has been a significant amount of new research regarding sports-related concussions in high school athletes, including
More informationTABLE OF CONTENTS SECTION I: ADMINISTRATION OF MEDICATION(S) AND MEDICAL INTERVENTIONS DURING SCHOOL HOURS
TABLE OF CONTENTS SECTION I: ADMINISTRATION OF MEDICATION(S) AND MEDICAL INTERVENTIONS DURING SCHOOL HOURS Prescription Medication Administration...2 Parent/Guardian Responsibility...2 School Responsibility...4
More informationFamily Day Care Services
Enrolment Details Date: A parent or guardian who has lawful authority in relation to the child must complete this form. Brief explanation of lawful authority is found at the end this form. Licensed children
More informationPublic Act 03-211 An Act Concerning the Provision of Medical Care for Students Health Care Needs
To: School Nurse Supervisors School Medical Advisors From: Cheryl Carotenuti, Health Promotion Consultant State Department of Education Date: September 29, 2003 RE: Public Act 03-211 An Act Concerning
More informationThe Public Schools of Verona, New Jersey
The Public Schools of Verona, New Jersey Procedure for Epi-Pen administration in the Verona Schools 1. The school nurse will provide the parent with the paperwork that must in place for epinephrine administration.
More informationAvon Seedlings Program 2015-2016 An Academic Preschool and Childcare Opportunity
Avon Seedlings Program 2015-2016 An Academic Preschool and Childcare Opportunity REGISTRATION FORM I hereby apply for enrollment of my child in the Avon Seedlings Program. Child s Gender: Date of Birth:
More informationBOARD OF EDUCATION Cherry Hill, New Jersey Policy 5141.21
BOARD OF EDUCATION Cherry Hill, New Jersey Policy 5141.21 ADMINISTRATION OF MEDICATION (POLICIES AND PROCEDURES CONCERNING ADMINISTRATION OF MEDICATION CODE PURSUANT TO N.J.S.A. 18A:11-1, 18A:40-4, 40-12.3
More informationStudent Health - Procedures for Life-Threatening Asthma Attacks 5600.5 and Systemic Allergic Reactions
Student Services Student Health - Procedures for Life-Threatening Asthma Attacks 5600.5 and Systemic Allergic Reactions I. Introduction. A. With no prior notice, life-threatening asthma attacks or systemic
More informationLIFE-THREATENING ALLERGIES POLICY
CODE: C.012 Program LIFE-THREATENING ALLERGIES POLICY CONTENTS 1.0 PRINCIPLES 2.0 POLICY FRAMEWORK 3.0 AUTHORIZATION 1.0 PRINCIPLES 1.1 Halifax Regional School Board will maximize the safety of students
More informationMEDICATION ADMINISTRATION TO STUDENTS
540 540 SECTION 540 MEDICATION AND FIRST AID SECTION 540A - MEDICATION MEDICATION ADMINISTRATION TO STUDENTS Medications are given to students in the school setting to continue or maintain a medical therapy
More informationJHCF-R2. Food Allergy Guidelines September 4, 2014. Alexandria City Public Schools School Health Guidelines Managing Food Allergies in Schools
Food Allergy Guidelines September 4, 2014 Alexandria City Public Schools School Health Guidelines Managing Food Allergies in Schools 1 Alexandria City Public Schools School Health Guidelines Managing Food
More informationTECHNOLOGY USAGE ACKNOWLEDGEMENT
TECHNOLOGY USAGE ACKNOWLEDGEMENT (Grades 3-8) Computers, networks, and online communications and information systems such as the Internet and email are becoming more commonplace in our classrooms and media
More informationHEALTH REQUIREMENTS & SERVICES: MEDICAL TREATMENT
DESCRIPTOR TERM: Students Millard District Policy File Code: 6200 1 st Reading: 05-08-14 HEALTH REQUIREMENTS & SERVICES: MEDICAL TREATMENT Purpose The purpose of this policy is to authorize school personnel
More informationADMINISTERING MEDICINES TO STUDENTS
Adopted June 1977 Revised November 1985 Revised April 2004 Revised September 2007 APS Code: JLCD Students shall not be permitted to take medication while at school unless such medication is administered
More informationSchuylkill Haven Area High School ***All sessions will be held at the Schuylkill Haven High School***
Registration Information Sheet Registration is due Wednesday, June 17, 2015 at 8a.m (no exceptions) Session Dates: June 22, 2015 July 17, 2015 Location: Schuylkill Haven Area High School ***All sessions
More informationCALCASIEU PARISH SCHOOL BOARD HOSPITAL/HOMEBOUND 1509 ENTERPRISE BLVD., LAKE CHARLES LA 70601 TELEPHONE: 337.217.4980, EXT. 3607 FAX: 337.217.
THIS FORM TO BE COMPLETED BY THE SCHOOL COUNSELOR AND FAXED TO THE DEPARTMENT Document: HHB 00 Title APPLICATION FORM FOR SERVICES Revision Date: 9/15 Date: Page: 1 of 1 STUDENT ID STUDENT NAME BIRTHDATE
More information210. USE OF LIFE SAVING MEDICATIONS. 1. Purpose
SHALER AREA SCHOOL DISTRICT No: 210 SECTION: PUPILS TITLE: USE OF LIFE SAVING MEDICATIONS ADOPTED: JULY 13, 1998 REVISED: JUNE 22, 2005; DECEMBER 13, 2006; JANUARY 11, 2012 210. USE OF LIFE SAVING MEDICATIONS
More informationMontessori Children s House Registration Form. Child s Name: Start date: Place of Employment. Place of Employment
Montessori Children s House Registration Form Child s Name: Start date: Date of Birth: Nickname: Mother s Name: Mother s Address: Contact Numbers Place of Employment Work Address Work Phone Social Security
More informationBurlington Public Schools. Life Threatening Allergy Procedures and Guidelines
Life Threatening Allergy Procedures and Guidelines In accordance with the Massachusetts Department of Elementary and Secondary Education s Guidelines on Managing Life Threatening Food Allergies in Schools,
More informationIllinois State Board of Education
Illinois State Board of Education April 2015 Guidance Document Self-Administration and Self-Carry of Medications for Asthma and Allergy (PA 98-0795) This document is intended to provide non-regulatory
More informationChilds Name: Service:
Childs Name: Service: Long Day Care Enrolment Form Updated January 2015 CHILD S DETAILS Childs First Name: Surname: Child s Residential Address: Child s CRN number call centrelink if you do not have one,
More informationDEFINITIONS: For purposes of this policy, the definitions included in this section apply:
STUDENTS Administrative Procedures 516A Administering Prescribed Medication in School Students may require prescribed medication at school in order to benefit from their educational experience. The following
More informationAdministration of Medication in Schools
Michigan Department of Education Michigan Department of Community Health Administration of Medication in Schools MODEL SCHOOL NURSE GUIDELINE Original Date of Issue: 2014 Michigan Department of Education,
More information