HEALTH CENTRE FORMS BOARDERS 2016

Transcription

1 Dear Parents / Guardians HEALTH CENTRE FORMS BOARDERS 2016 The attached medical forms are essential documents for the care of our boarding students at Marist College Ashgrove. Please complete each section of the forms and return them completed, PRIOR to Friday 30 October It is imperative that changes to this information be updated as they occur for your son s/guardian s wellbeing. We request a formal copy of your son s immunisation history to be kept on file in the Health Centre. This is necessary for both Boarding and Day students and will be used as a reference point in the event of any outbreak of a notifiable illness such as measles, where we may have to provide details to Public Health. Please attach a photocopy of your child s immunisation to date. For a true reflection of this you can access both the Australian Childhood Immunisation Register for 0-7 years and Brisbane City Council for other immunisations your child may have had including records your GP may hold. It is strongly encouraged that boarding students have adequate immunization against meningococcal, tetanus, hepatitis B, chicken pox, measles, mumps, rubella. Please note however that the Brisbane City Council vaccinates all Year 8 students for Hepatitis B and Year 10 students for Tetanus, Diptheria and Pertussis (whooping cough) with the Boostrix vaccine. This service is run independently of the Health Centre. All enquiries should be forwarded to the Brisbane City Council. It is possible for immunizations to be given at the College if parents/guardians have not previously organised this with local Medical Practitioners. You will find attached a consent form for the influenza vaccine which will be administered in 2015 approximately in April. This Fluvax vaccine is entirely optional. No reminders will be sent regarding this vaccination. The College has available to the boarding students the services of a Physiotherapist. The cost is approximately $90 with rebates available from your private health fund if applicable. The Nursing Staff will be responsible for making appointments for the students. Physiotherapy can only be given if the consent form is signed. We will endeavour to contact you prior to treatment; however this may not always be possible. Any consent for Fluvax and Physiotherapy will be considered ongoing until parents/guardians request it to cease. The medical provider for the College Health Centre is Walton Bridge Medical Centre, 976 Waterworks Rd, The Gap. Clinics are Monday through Friday mornings in the Health Centre and appointments are available at their Medical Centre at other times. These services are currently bulk-billed for those eligible for Medicare Cover. Specialist medical services and some scans/x-rays are not bulk-billed, however they are subject to significant Medicare rebate. Dental services are subject to private health fund rebate for those families having such insurance. We offer services within walking distance to Orthodontic facilities, and also a Podiatrist. Sometimes if your son/guardian is sick they may spend a night in the Health Centre. If this is the case, he will call and inform you and you will have the opportunity to speak to the Nurse on duty. We would also request that any parent/guardian initiated medication for boarding students Years 7 11 is kept in the Health Centre rather than in their boarding residence. This enables us to be aware of what your son/guardian is taking, whilst limiting his exposure to large amounts of pharmaceuticals in his boarding residence. Please provide Asthma or Anaphylaxis action plan completed by a GP PRIOR to your son commencing at the College. Any other queries regarding medical services can be directed to the Health Centre staff during office hours. Yours sincerely Health Centre Staff Marist College Ashgrove Telephone: healthcentre@marash.qld.edu.au

2 SCHOOL PROCEDURES IN THE EVENT OF ACCIDENT OR ILLNESS Ailments Students will report to Health Centre. The Registered Nurse on duty will assess, treat, or refer the student to other health professionals or parents/guardians. All treatment will be documented. Minor injuries Students will report to the Health Centre or first aid will be administered on site. Health Centre visits will be documented in the student diary or should the student present without his diary a note will be given for Head of House or class teacher. Serious ailments/injuries requiring doctor or hospital admission Parents/guardians will be contacted if at all possible according to information on medical form. First Aid will be administered by school nurse or, other staff members immediately present. The school nurse will decide if the student should be taken to hospital immediately or a doctor called. In an emergency or on the advice of attending doctor, a student will be transferred by ambulance to hospital. A College representative will stay with the patient until his relatives attend the hospital if necessary. MEDICATION PROCEDURE It is imperative that Health Centre Staff be aware of all medications taken by students. Assistance will be given by the School Nurse in the administration of prescription medication when documentation is received from parents/guardians or as prescribed by the school doctor. Instructions of change to the original dose of long term or restricted medications must be in writing from prescribing doctor. Short term prescription medication will only be administered if the container states, name, dose and is labeled in the original container. Complementary therapies ordered by parents/guardians may be stored at the College Health Centre on behalf of the parents/guardians but the student must self-medicate. The school nurse will arrange for filling of prescriptions for boarders at a local pharmacy. All medications administered by the school nurse or any other staff member will be recorded. ANAPHYLAXIS/SEVERE ALLERGY PROCEDURE A kit with up to date action plan plus adrenaline auto injector if necessary is to be kept in Health Centre during school terms. Parents/guardians are requested to communicate allergies of medical significance to their son s Head of House and Health Centre. Parents/guardians need specifically to flag this on camp and excursion forms also. -2-

3 MARIST COLLEGE ASHGROVE MEDICAL REQUEST FORM BOARDING STUDENTS 2016 Year Level: Surname: Christian Names: Date of Birth: Address: House: Home Phone No: Mother s Name: Mother s Work No: Mother s Mobile: Father s Name: Father s Work No: Father s Mobile: Address: IF NOT LIVING WITH PARENTS Please provide Guardian s Name and Contact details: MEDICARE NO: Reference No: Expiry / Name and Number of Private Medical Fund: Hospital treatment desired: PUBLIC / PRIVATE (please circle) St. Andrew s Private Hospital requires payment upon admission to emergency. Do you consent to pay on admission? YES / NO (please circle) In case of emergency (if parent/guardian is unavailable): Contact (1): Contact (2): Phone No.: Phone No.: Every reasonable effort is always made to contact a parent/guardian in the case of major illness or injury. However, advance permission is required to facilitate treatment of minor conditions, and of major conditions in the event of a parent/guardian being out of contact. General Practitioners from Walton Bridge Medical Centre visit each weekday and are on call for emergencies. These services are currently bulk-billed. Specialist medical services are not bulk-billed however are subject to significant Medicare rebate. Dental and physiotherapy services are subject to private health fund rebate for those families having such insurance. PERMISSION TO ARRANGE TREATMENT/ MEDICAL CONSENT: I, being the parent/guardian (Student s Full Name) do hereby authorise and request the Headmaster of Marist College Ashgrove, Queensland, or his nominee, to allow any duly qualified Medical Practitioner registered within Australia, to give medical/surgical treatment, including general anesthesia where necessary. We provide the information contained in this form and consent to the procedure set out following an event, injury or illness. I further authorize the College Registered Nurse, or her/his delegate to administer to my son/guardian: 1. non-prescription medications for the alleviation of minor conditions, at that nurse s discretion, 2. prescribed medications as directed by a legally qualified Medical Practitioner. I undertake to inform you of any changes to the information in this form as they occur, as necessary. Names of Parents/Guardians (please print): Signature of Mother/Guardian: Signature of Father/Guardian: Signature of Witness: -3-

4 It is the responsibility of parents/guardians to provide the College with updated information as it occurs. We can only do our best with the information that we have been provided, in the case of an emergency and they do happen. We need to have current information for your son's/guardian s sake. MEDICAL INFORMATION Immunisation Records: We request a formal copy of your son s immunisation history to be kept on file in the Health Centre. This is necessary for both Boarding and Day students and will be used as a reference point in the event of any outbreak of a notifiable illness such as measles, where we may have to provide details to Public Health. Please attach a photocopy of your son s immunisation records to date. For a true reflection of this you can access both the Australian Childhood Immunisation Register for 0-7 years and Brisbane City Council for other immunisations your child may have had including records your GP may hold. IMMUNISATION RECORD: Photocopy of immunisation records attached TYPE YES NO Hepatitis B Hepatitis A Meningococcal Boostrix Tetanus or ADT/CDT Measles/Mumps/ Rubella Has your child had Chicken Pox or the vaccine Polio Other Vaccinations DATE OF MOST RECENT INJECTION Medications: If your son/guardian is taking regular prescription medication that requires him to be given this during school, a letter will be required to confirm this from his treating Doctor. If yes please tick If your son/guardian has Diabetes Asthma Epilepsy Allergies (mild) Anaphylaxis If your son/guardian suffers from one of the conditions listed, we would appreciate you attaching an Action Plan with this form. All other medical emergencies will be treated with the appropriate First Aid care. Past operations year year year Other past medical conditions (please specify) Are there any health issues that the school should be aware of (e.g. skin disorders, Attention Deficit Disorder, disability, fainting, Hepatitis B carrier, incontinence, anxiety or psychological issues): These non-prescription medications are held in the Health Centre Please initial beside EACH medication which you authorise nursing staff to administer to your son/guardian if required. Paracetamol (e.g. Panadol) Ibuprofen (e.g. Nurofen) Panadeine Sudafed Cold and flu tablets Throat Gargles _ Throat lozenges Gastrolyte Minor Allergies (e.g. Telfast) Antacids (e.g. Mylanta) Stingoes Cold sore cream Anti-inflammatory gels (e.g. Arnica) Antifungal creams _ Sports rubs Vicks Vapor Rub Vitamin C -4-

5 Is there any personal medication to be held at Health Centre at parents /guardians request? PHYSIOTHERAPY I give permission for to receive physiotherapy treatment as and when required. I agree to pay all costs incurred direct to the Clinic on receipt of invoice. Parent / Guardian Date INFLUENZA VACCINE I give permission for to receive the Fluvax injection. I agree to pay the cost of the vaccine which will be billed to my account. This request is ongoing until your son/guardian departs the College. Parent / Guardian Date Tear off for your information FOR YOUR INFORMATION All Star Orthodontics Dentists - John O Hare / David Elliott Podiatrist Andrew Barlow or Walton Bridge Medical Centre