RN3 Forms
Health Forms
HEALTH RECORDS: The school nurse maintains a current health record on each student enrolled at Franklin County Technical School. This record contains the data from each of the services which you have just reviewed. If your child receives any immunization booster or has a physical exam, please forward this to the school nurse to facilitate accurate record maintenance. It is also important that the school nurse be alerted to any significant health problems which your child may have. Upon graduation from Franklin County Technical School, the health record will be given to each outgoing senior.
STUDENT EMERGENCY INFORMATION: Each year, student FCTS EMERGENCY INFORMATION FORMS are available on the Health Office website for you to fill out. Please list persons who are to be notified in an emergency. Obtain the consent of the person you are listing. If you change jobs or move during the school year, please remember to update the information and notify the school. Students can be released only to the parent or to the alternate person you have listed. It is essential for your child that we are kept up-to-date. Please note form below.
MEDICATION DURING SCHOOL HOURS: the school nurse must receive written, signed, and dated form from parent/guardian, with part 2 completed by the primary care physician. The medication must be brought to the nursing office in the original container by a parent or guardian. (students are not permitted to carry medications to school) Do NOT bring in medication in an envelope or unmarked container. It is imperative that the label on the medication bottle match the written physician order for that medication.
FIELD TRIP MEDICATION PERMISSION: before a student who takes medication can participate in a school sponsored field trip, the health office must receive the written, signed and dated form from parent/guardian.
INHALERS may be carried by a student, provided the appropriate forms are filed in the nursing office, and your child is aware that he/she is not to share the inhaler with another student.
EPI-PENS may be carried by a student, provided the appropriate forms are filed in the nursing office, and your child is aware that he/she is not to share the Epi-Pen with another student. If your child has been diagnosed with a Life Threatening Allergy the following must be provided prior to the start of school A physician and parent signed Allergy Action Plan, A clear 2 X 2 photo of child's face, An unexpired Epi- Pen in a pharmacy labeled box.
INSULIN may be carried by a student, provided appropriate forms are filed in the nursing office, and your child is aware that he/she is not to share the insulin/use of glucometer/snacks with another student. The diabetic or hypoglycemic student may also carry & use their blood glucose measuring device (glucometer) and equipment as prescribed by your doctor; the student can carry and eat a snack as directed by your doctor.
Digestive enzymes medication (Cystic Fibrosis) will be readily accessible/available to the diagnosed student, provided the appropriate forms are filed in the nursing office and the medication has been provided.
Lactose Intolerance aids will be readily accessible/available by the diagnosed student, provided the appropriate forms are filed in the nursing office (a doctor note with the diagnosis of lactose intolerance written on it) and the medication has been provided. The lactose intolerance aids are considered a food substance and so don’t require a doctor order for the medication, however, in order for a milk substitute of another beverage at lunch to be provided, it is necessary for the food services director to provide proof to the State that milk substitution is warranted.