Randolph School District

The goal of school health services is to promote safety and remove or reduce barriers to learning. We know that students who are healthy learn more, and students who learn more are healthier. We want every student in the district to have a healthy and rewarding educational experience.

• Immunization: Required by the State of Wisconsin – State Statute ss.252.04 and 120.12.(16). Please fill out completely or attach a copy of the students immunizations on the Student Immunization Record form. Immunization requirements for all grade levels (4k-12) are specified in the Wisconsin Immunization Requirement. If you are uncertain of your child’s status, please consult with your health care provider, or you may view your child’s record on the Wisconsin Immunization Registry (WIR). Since schools are required to review student immunizations annually, it is helpful if you complete the Student Immuniztion Record when your child receives new immunizations and return to the school office.
• Medication: Medication should be administered to the students by their parents/guardians at home whenever possible. If order to have medication given to your child at school, the completed Medical Consent Form must be on file at the school. A new form must be completed annually. Students are not allowed to carry any over-the-counter (OTC) or prescription medications at Randolph Schools and all medications must be dropped off by a parent/guardian. All medications are dispensed from the health room/office after the medication forms are completed. The only exception is for inhalers and emergency medications that have been properly signed off by your child’s physician. 

Prescription Medication: Must be supplied in the original phamacy-labeled package, and the package mys specify the name of the student, prescriber, name of the prescription drug, dosage, effective date, and the directions in a legible format. 

• A Medical Concent Form must be signed by a licensed healthcare professional and consented to by a parent/guardian. 

Over-the-counter (OTC) Medication:  Must be supplied int he original manufacturer’s package, ,not expired, and the package must list the ingredients and recommended theraputic dose in a legible format. 

• A Medical Consent form must be signed and consented to by a parent/guardian annually, The administration of non-prescription drug products in a dosage other than the recommended theraputic dose is considered a Prescription Medication. 

Stock Medication: Randolph School District will stock four medications in the health room: acetaminophen(Tylenol), ibuprofen(Motrin), diphenhydramine hydrochloride(Benadryl), and hydrocortisone 1% cream.

• A Stock Medication Consent form must be signed and consented to by a parent/guardian annually before medication can be administered. 

Chronic Health Conditions: Make sure to update the school nurse with any concerns or health issues. It is important for us and your child’s safety that we have the proper supplies, medications, and an individualized health plan at school so we can best care for your child in case of an emergency.  Please also ensure that the following information is accurate and updated at the beginning of each school year: parent/guardian contact information, emergency contacts, current health conditions, and health care provider.

• Severe Allergy Action Plan – Any Student who has an EPI-PEN must have a completed Allergy Action Plan. Parents fill out the top section and a physician must sign the bottom section. 
• Asthma Action Plan – Students with asthma must have a completed Asthma Action Plan. Parents fill out the top section and a physician must sign the bottom section.
• Seizure Disorder Action Plan – Students with a seizure disorder must have a completed Seizure Disorder Action Plan signed by a parent.
• Diabetes Action Plan – All students with diabetes are encouraged to store extra supplies and snacks in the health room/office cabinet.  Please make an appointment each year with their endocrinologist and have a Diabetes Medical Management Plan completed by their physician before the start of school. Physicians can also use their own forms.  

Diatary Restriction: If your child needs a meal or snack accommodation while at school from food services due to an allergy, celiac disease, gluten intolerance, lactose intolerance, or another condition, a Dietary Request Form must be complerted annually and signed by your child’s health care provider. Once completed, please return to the school office.

It is important that you notify the school nurse if there are any medical changes during the school year. Please call us us if you’d like discuss your child’s health condition or need help completing any forms.