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Nurse Forms

  • Forms

    Presciption Medication: Long Term

    Permission form for allowing school personnel to administer medical provider prescribed medication for more than 15 days during the current school year. A written statement indicating students name, DOB, medication name, dose, route, and frequency that is signed and dated by a medical provider with prescriptive authority in Alaska is required will also be accepted. Must be renewed annually.


    Prescription Medication: Short Term 

    Permission form for allowing school personnel to administer medical provider prescribed short-term prescriptions for a period of time not to exceed 15 days. A current pharmacy label on the container will be accepted as the legal prescriber's authorization for short term medications.



    Parent permission form for requesting the district give non-prescription medicine under certain conditions. Use this form for the current school year for any non-herbal, non-homeopathic medications that can be purchased at a store. Must be renewed annually.


  • Medication at school

    If your child needs medication this school year (including inhalers), a new Long Term Medication form must be submitted. If your child is on medication for ADHD please try and bring the form and pills to school on August 12th. If that is not possible, and you need to bring on the first day of school, please be prepared to wait as paperwork is reviewed, and the pills are counted. ASD policy prohibits students from bringing prescription medication to school. It must be brought in by an adult. Some over-the-counter medications may be administered by the school nurse upon parental completion of the Nonprescription Medication Request form. All medication must be provided in the original container. Loose pills that come to the school in a baggie will not be given.

    Free Sick Student Cliparts, Download Free Sick Student Cliparts png images, Free ClipArts on ... Feeling ill at school - what to do?

    Students becoming ill during the school day must report to the nurse. If it is necessary to go home or to a doctor, the nurse will inform the parent/guardian and the student will be released from school.

    Although we stress the importance of good attendance, a student who appears ill should remain at home. Please do not send sick students to school to be examined by the school nurse. This may unnecessarily expose many others to illness. 

    Sport participation - inhalers/Epi-pen/Emergency Medications

    If your child is participating in after-school sports and has severe allergies/asthma requiring an epinephrine autoinjector/inhaler, you must provide one for your child to carry during this after-school activity. Be sure that the coach knows where your child’s epinephrine auto-injector will be kept, so it can be retrieved quickly in case of an emergency.  Self-carry designation is part of the annual allergy or asthma plan from healthcare providers.

    All shots up-to-date

    Please be sure that your child’s hepatitis and tetanus immunizations are up-to-date. Those students who are out of compliance with their hepatitis and tetanus shots will be excluded from school and their class schedule will be withheld until proof of immunization is provided. Immunization reminder letters will be mailed, in August, to all students who will be out of compliance by the start of the school year.

    PE Excuses

    All PE excuses are handled through the nurse’s office. Have your child bring the PE excuse to the nurse, not the PE teacher. The nurse will make alternative placement arrangements and notify the teacher. If a student needs to be out of PE for more than three days, a written request from a physician is necessary. The note must indicate the reason for, and specify the length of, the PE exclusion and include a return date. When a physician writes a PE excuse for two weeks or fewer, the student will be placed in the library. In order for students to obtain course credit, PE excuses greater than two weeks require the student to be assigned to another class, until cleared to return to PE by their physician.