Charlene Wilson, RN
SBISD Clinic Forms
Nonprescription (OTC) Medication Form
Prescription Medication Form
Special Healthcare Procedure Form (Nebulizer/Injections)
Student Held Epi-Pen Form
Student Held Inhaler Form
MAM (Memorial Assistance Ministeries)
When to keep your child home from school:
1 Fever of 100.0 F or greater is an indicator of a contagious illness and your child should remain home until the fever subsides without the benefit of a fever reducing medicine.
2 Sore throat accompanied by a fever or rash.
3 Diarrhea and/or vomiting.
4 Nasal or respiratory drainage that is thick, green, yellow or grey is a sign of infection.
Before entering 7th grade, students must have a Tdap (within the last 5 years), 2nd Varicella and a Meningococcal vaccine. When you receive our request and if your student has already received the immunizations, PLEASE send us a copy so we can update our records. Please send a copy when they receive the immunizations if they have not had them already.
Rising Senior Parents:
Your student will need to have a meningitis vaccine for college entrance in the Fall of 2017. Please check with your medical provider and make sure that your son or daughter has had at least 1 meningitis vaccine within the last 5 years. If they have not had a meningitis vaccine or if they had one more than 5 years ago, you should get this vaccine ASAP. I will mail requests home for those Juniors in need of a second meningitis vaccine in their last report card this school year.
Please provide vaccine documentation to the school clinic so that our records will be up to date.
What is bacterial meningitis?
Bacterial meningitis is an inflammation of the membranes that cover the brain and spinal cord, according to the Centers for Disease Control and Prevention. The illness can progress rapidly and cause death or permanent disabilities, such as hearing loss, brain damage, or loss of limbs. A descriptive video explaining bacterial meningitis can be viewed at http://www.youtube.com/watch?v=h2-U1S74OH0
Studies suggest that college students have a higher risk of contracting the illness because they live and work in close proximity. More information is available online at www.cdc.gov/meningitis.
Who needs the meningitis vaccine?
Students are required to show proof they have received the meningitis vaccine if they are less than 30 years old and are first time Texas college/university students.
Prescription and nonprescription medications may only be administered to students when parents/guardians have provided the medication from a recognized pharmacy, in the United States, in an appropriately labeled, original container and when the medication is in the original form as purchased or dispensed by a pharmacy in the United States or a physician licensed to practice in the United States.
The Physician’s Statement for Administration of Prescription Medication is the designated district form for physician/parent request for administering prescription medication to students. This form MUST be signed by the prescribing physician before the medication may be given at school.
The Parent’s Statement for Administration of Nonprescription Medication is the designated district form for a parent to request the administration of nonprescription medication to students. Any over the counter medication dosage exceeding the recommended dose on the label must be signed off by a physician on the Prescription medication form. All nonprescription / OTC (over the counter) medication must be appropriately labeled in the original container and not expired. This does include cough drops.
The Physician’s Statement for Administration of Special Health Care Services will be required when medication is to be administered by special procedure, e.g., nebulizer treatments, via body tubes, injectables. The appropriate procedure/protocol for the special service must be sent to the physician for his/her review.
All statements for medication administration and special health care procedures must be renewed at the beginning of each school year. Student held inhaler and Epi-Pen forms are also availble above and must be signed by the prescribing physician, parent, and student. These forms need to be in the clinic prior to the student carrying these medications to school. Medications must be picked up from the clinic by the last day of school. Any medications left will be disposed of properly.
Herbals, home remedies, and dietary supplements do not generally come with a United States licensed doctor’s order, an approved dosing schedule, known side effects, FDA approval or a list of ingredients so they will not be given while at school. As with any medication, the parent is welcome to come to the school and administer medication to his/her child. Medications are available to print off above. Any students found carrying medication will receive disciplinary action from an administrator.
Immunization notices will be sent home in the mail prior to due dates to allow plenty of time to make a doctor’s appointment to get them done. Please feel free to get these shots done after the FIRST notice. Immunizations marked OPT. are considered optional but recommended. Three notices will be sent home prior to the due date if we have not received any new shot records. Students will be excluded unexcused after the due date until proper records are received in the clinic.
We do check ImmTrac, the state registry for immunizations. You may want to ask your Physician if they put immunizations in ImmTrac, and if they do not, please ask them to do so. We are able to locate some immunizations due on ImmTrac if updated.
In some cases you may already have had a due immunization and we just do not have a record of it so please copy the shot record and bring it to the clinic. Notices for summer immunizations that are due prior to the first day of school (including 7th grade required immunizations) will be sent home prior to the end of the previous school year. Please feel free to get these done before school is out for summer and bring the record to the clinic.
Immunization records due by the first day of school may be turned in during new student registration to the clinic or may be brought to WAIS Welcome. If immunization records have not been received by this date your student’s schedule will be held until the records are received and your student will not be allowed to start the first day of school. Thank you for helping keep Westchester Academy 100% with Immunization Compliance!!
State required screenings for students:
Sixth Grade: Scoliosis
Seventh Grade: Hearing,
Acanthosis Nigricans (Risk Assessment for Type 2 Diabetes)
Ninth Grade: Scoliosis
All new students to SBISD:
Acanthosis Nigricans (Risk Assessment for Type 2 Diabetes)