The goal of Health Services is to help students develop strategies to manage health issues and enhance personal wellness. Vision and hearing screenings, physical and immunization compliance, and other public health mandates are managed by Health Services. Daily direct nursing service includes illness and injury assessment and intervention, emergency care, medication administration, and health counseling.
- Asthma Action Plan
- Authorization of Treatment
- Certificate of Child Health Examination
- Dental Examination Record
- Food Allergy & Anaphylaxis Action Plan
- Freshman Requirements
- Medication Form
- Release of Information
- Religious Exemption
- Seizure Action Plan
- Senior Requirements - Meningitis Vaccination
- Special Education Forms
- STRIVE Forms
The State of Illinois passed a bill that now requires students with asthma to provide the school nurse with an “Asthma Action Plan.” The “Asthma Action Plan” should be a written plan developed with a student’s medical provider to help control their asthma. Parents or guardians must provide the school nurse with written authorization for self-administration and self-carry of asthma medication. Permission needs to be renewed each school year. The “Asthma Action Plan” must be kept on file in the school nurse’s office.
Physician Authorization of Treatment is to be completed by a physician and signed by a parent/guardian for students who require specialized nursing care during the school day.
Students with diabetes are required to have a Diabetes Medical Management Plan (DMMP) on file. A new plan must be provided to the school ever school year and updated as needed.
The State of Illinois passed a Public Act in 2006 that permits students to carry and self-administer epinephrine auto-injectors with the written authorization of a physician and parent/guardian. Authorization needs to be renewed each school year. A completed Food Allergy & Anaphylaxis Emergency Care Plan should be on file in the nurse’s office for students with severe allergies or who are at risk for anaphylaxis.
All freshmen are required by law to have a physical examination, completed on a Department of Human Services State of Illinois Certificate of Child Health Examination form. Freshmen must present this current physical examination on freshman distribution day. The physical examination needs to be dated within the 12 months prior to freshman distribution day. Your physician will need to sign this form in two places; 1. The immunization portion; and 2. The physical examination portion. A Parent/Guardian needs to complete, sign, and date the “Health History” section on the back of the physical form prior to the appointment with a health care provider. If your student is interested in participating in athletics, an additional copy of the Certificate of Child Health Examination must be submitted to the Athletic Department.
In addition to the Certificate of Child Health Examination form, the Illinois Department of Public Health also requires that students entering grade 9 have a dental exam on file. School dental examinations must have been completed within 18 months of freshman year. The form you will need to submit for this requirement is called the “Proof of School Dental Examination Form.
If your student requires medication at school, the medication authorization form must be on file in the nurse’s office. You may download this form using the steps listed above. This form, signed by both a physician and a parent/guardian, is required for both prescription and over-the-counter medications including Tylenol, aspirin, Midol, antacids, etc. as well as asthma inhalers and Epi-pens. Students may carry inhalers and Epi-pens with them during the school day.
The Illinois Department of Public Health requires that students entering 12th grade must be immunized for meningococcal disease. This vaccination will prevent your student from a severe form of bacterial meningitis as well as other illnesses caused by this bacterium.
All 12th graders will need to show proof of receiving two doses unless the first dose was administered after 16 years of age. In this case, only one dose after 16 years of age is required.
Documentation must be provided to the school nurse before Distribution Day in August. You can submit documentation to the nurse anytime between now and distribution day. If you have questions about the meningococcal vaccination, please contact your school nurse.
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Cary-Grove High School
Martha Manno, MSN, RN, PEL-CSN
Phone: (847) 639-3825 Ext. 4130
Fax: (847) 639-3873
Crystal Lake Central High School
Linda Haman, RN, BSN, ILCSN, MSEd
Phone: (815) 459-2505 Ext. 2265
Fax: (815) 459-4169
Crystal Lake South High School
Colleen Wing, MSN, RN, PEL-CSN
Phone: (815) 455-3860 Ext. 3230
Fax: (815) 893-5255
Prairie Ridge High School
Sarah Folkening, BSN, RN, PEL-CSN
Phone: (815) 479-0404 Ext. 5215
Fax: (815) 459-8993
FLS (Crystal Lake South)
Andrea Miculinich, MSN, RN, PEL-CSN
Phone: (815) 455-3860 Ext. 3273
Fax: (815) 893-5255