2003-2004 SCHOOL YEAR

Dear Parents/Guardians,

If your child is injured or becomes ill at school, he/she will be sent to the school clinic which is staffed by a nurse and volunteers.  We keep a record of your child’s visit and notify you by way of a Nurse Visit Report brought home to you by your child.  It will need to be reviewed, signed and sent back to the school office the following school day.  We will also notify you of your child’s clinic visits for anything other than minor cuts, etc.

If there is ever anything significantly wrong with your child, you will be called to pick him/her up.

Please note that the clinic volunteers are NOT allowed to dispense any medications to your child.  Contact the school office if medications are to be given.

Please provide us with the information below to help us to be more aware of potential problems with your child.

Maria Sofia-Stone, RN

Health Services Director

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Child’s name___________________________Grade_____________________

Medical Problems_________________________________________________

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Regular medications or treatments__________________________________

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Allergies________________________________________________________

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Comments_______________________________________________________

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Parent/Guardian Signature _______________________________________________Date____________