School Entry Information Letter for Parent/Guardian & Medical Providers
Authorization for Exchange of Information
Student Health History
STUDENT IMMUNIZATION & LIFE THREATENING HEALTH CONDITIONS:
SEVERE FOOD ALLERGY
Request for Special Dietary Accommodations Form
ACCOMMODATING STUDENTS WITH DIABETES
Policy 3415 - Accommodating Students with Diabetes
Notice 3415 - Voluntary Parent-Designated Adult Notice of Intent
MEDICATION AT SCHOOL
Policy 3416 - Medications at School
Procedure 3416 - Medications at School
3416F - Authorization for Administration of Medication at School
3416L - Letter to Parent/Guardian Regarding Life Threatening Health Condition
DAYTON SCHOOL DISTRICT HEALTH SERVICES
The Dayton School District Nursing Staff is committed to ensuring a healthy and successful school year. We are writing this letter to summarize some of the things we do and how we can help you and your child have a successful school experience.
Immunization Certificates are forms that all students preschool through 12th grade are required by law to complete in WA State (see WA State Law RCW28A.210.160). All students must be immunized as specified by WA State or have a medical or religious exemption at school. We can provide you a copy of the Immunization Chart. This form can be printed by your child’s medical provider or by our nursing staff; a parent/guardian must sign it and turn it in before the start of school.
Health History/Serious Health Conditions
Parents/Guardians of all students should complete a Student Health History Form before the start of school. If your child has a life threatening illness or condition, parents/guardians must notify and complete the required paperwork prior to the start of school in order to avoid exclusion from school. If your child has an allergy, asthma, diabetes, seizures or other serious chronic health condition which may require medication, treatments or additional health planning please make an appointment with your child’s healthcare provider. Your child’s healthcare provider can write orders for treatments and medications to be administered at school. We must have forms in place to administer medications even those that are over the counter. Forms are available online and in the office and additional forms will be added this summer. See Washington State Law RCW28A.210.320. There are other forms that may be helpful to us as well in caring for your child with a life threatening medical condition and those forms include Asthma Plans, Diabetes specific forms, Severe Allergic Reaction forms, etc. These can also be located online or the office.
School Medication Administration
The parent or legal guardian and healthcare provider must complete and sign an Authorization for Administration of Medication at School form for all medications (prescription and over the counter) to be given at school. This form is available online or at the office. They must be completed with each new school year.
A parent or legal guardian must bring all medication, accompanied by the form to the office in original container and not expired. They must have original label with healthcare providers name, medication name, strength, dosage, date and time for administration and dispensing pharmacy. Parent/guardian must supply over the counter medications.
If your child has a life-threatening condition such as asthma, diabetes, severe allergic reaction, etc., permission may be granted to carry medications such as an epi-pen, inhaler, glucose tab, etc. on his or her person by their healthcare provider.
All health information is confidential and will only be shared with school personnel on a need to know basis. We ask that you complete the Authorization for Exchange of Confidential Student Information as well so that we can communicate with your child’s healthcare provider to should a concern, question or additional need arise.