Fenwick High School



Dear Parents or Guardian,We are looking forward to the arrival of your child at Fenwick High School. The State of Illinois requires a Complete Health Examination Form to be completed within one year prior to entering the ninth grade at Fenwick High School. A copy of this form can be found on the Fenwick website under Student life-Health office and or Magnus Health System. If there are any further questions while completing this process, please call the School Nurse, Donna Pape, at 708-386-0127 EXT: 170 or Fax: 708-386- 3052. All Parents should receive an e-mail from Magnus, providing your username/password to access your child(rens)’s Magnus Health SMR account(s). If there are questions please contact customer support at Magnus Health SMR by Phone at 877-461-6831 or by e-mail at service@. All privacy and HIPPA statements can be found at the bottom of the Magnus Health log page.* All forms are requested on or before July 1, 2017A Dental form is recommended, but not required.Health Examination: State of Illinois Certification of Child Health Examination (11/2015) this identification code to the form is located on the bottom left hand corner of the left page.Immunization Section:Should be signed and dated by the physician or heath care provider.If the physician does not have a list the immunizations, you may request records from your child’s grammar school or previous doctor.Health History Section: Must be completed by a parent or plete allergies on the upper left hand corner of the form and medications on the upper right hand corner of the form. medications, Circle Yes or No after the health questions and sign and date the bottom of this section.Physical Examination Section: Will need to be completed by a physician, physician's assistant or an advance practice nurse. The physician is required to complete the Diabetes Screening. The physician is required to check Yes or No for Physical Education and Interscholastic Sports. If Physical Education is checked No, the health examination must include a note stating the reason for NO Physical Education.*Sports Physical form: Is not required as a Freshman Student. Only The State of Illinois Certification Child Health Examination form is required.This health examination is required for sports participation.If there is an injury, please have a physician's note stating the restrictions and return it to the health office.If there is a need for a clearance from an injury, a physician's note must be returned to the health office.Medical Concerns: Are required by the State to have the appropriate forms on file.Medication Authorization form: Medication to be taken during school and during School related Activities:Students are allowed to carry and self-administer medication only if a physician completes a Medication Authorization form. Examples of these medications are: EpiPen, Inhalers and Insulin.Students may keep medication in the health office in a properly labeled container or bottle accompanied by an Authorization of Medication form.Over the counter medication should be taken only in the health office. A form labeled Authorization of Medication must be completed, along with Authorization for the Nurse to dispense the medication.Medications cannot be given unless these forms are completed. All Medication and Forms should be renewed yearly. Medication policy for allergies- The State of Illinois requires an Authorization of Medication form and an Illinois Food Allergy Emergency Action Plan form be completed by a physician and placed on file in the health office.Medication Policy for Asthma: An Authorization of Medication form can be completed by the Physician or the Parent can fill out the form Self- Administration permission form. Parents have to provide the prescription label, which contains the name of the medication, the prescribed dosage, and the frequency.**All Medication and Forms should be in the Magnus Health System by July 1st. All forms need to be uploaded on Magnus Health System on or before July 1, 2017. .If unable to make an appointment until after the date requested, the school nurse will need a note from a physician's office with the date and time of the scheduled appointment. Fax: 708-386-4323 Exclusion: The State of Illinois requires that students have all forms returned to Fenwick High School by the start of the new school year. Students may not be allowed to attend class, participate in sports or other activities until all forms are completed. Please call Donna Pape, R.N. BSN and Kitty Monty, CNA 708-386-0127 ext.: 170708-386-4323 Fax ................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download