Administration of Medication Request

Allergy Packet

Asthma Packet

Diabetic Medical Management Plan

Immunization Exemption Form

Medical Directive for Nutrition

Seizure Packet

Gastrostomy Tube Feeding Authorization Form

Gastrostomy Reinsertion Form

Tracheostomy Care Form

Prescription Medication Information

A student requiring prescription medicine at school must have a completed “Administration of Medication Request” form on file in the school office. This form must be completed by both the physician who prescribes the medication and the parent or guardian of the student prior to school personnel being permitted to administer medication. The form indicates the name of the student, name of the medication, dosage, time, possible side effects, expiration date of the physician’s order, etc. If a medication dosage changes, a new "Administration of Medication Request" form needs to be completed by the physician and parent/guardian. A copy of the complete board of education policy on prescription medication is available via the Marysville Schools Board of Education site.

Parents are to personally deliver all prescription medication to the main office at the school. Medication is to be in the original prescription container with the student’s name, date, medication name, current dosage and time(s) to be taken on the container label. It is the responsibility of the parent to refill all prescriptions as needed. If a student requires the same medication at home, most pharmacies will provide an extra pill bottle with a duplicate label. School personnel are not responsible for monitoring the supply of medication on hand in the school office for individual students. Prescription medication left over at the school following the completion of the school year will be properly destroyed by school personnel if not picked up by the parent by June 15. Leftover medication will not be sent home with the student. 

Non-Prescription Medication (Grades K-4)

If a parent feels it is necessary for a student to have non-prescription (OTC – over-the-counter) medication during school hours, a completed “Administration of Medication Request” form must be provided, along with a container of the medicine. An adult must bring the medicine into the school office. The clinic does NOT provide these OTC medications for students. This includes but is not limited to Advil, Tylenol, Tums, Hydrocortisone cream, calamine lotion, medicated cough drops*, cough/cold medicine, etc. If a completed form cannot be obtained in time, a parent or approved adult on the emergency contact list may bring the medication to school to administer at the time it is needed. The medication may NOT be brought into school by the student. Also, a parent must notify the school explaining the need for medication and provide the name of the approved adult who will be bringing and administering the medication to the student. This adult must also show identification to administer medications. 

*Non-medicated cough drops or throat lozenges may be brought in by a student in its original package WITH a note from a parent giving permission to administer. (Menthol, benzocaine, cough suppressants, numbing agents are considered medicinal ingredients.) Medicated cough drops will not be administered without an “Administration of Medication Request” form. 

Non-Prescription Medication (Grades 5-12)

Dispensing of non-prescription medication (OTC – over-the-counter) is discouraged at school. If a parent feels that it is necessary for a student to have non-prescription medication at school, including but not limited to Advil, Tylenol, Tums, Hydrocortisone cream, cough drops, calamine lotion, he/she should first understand that school personnel will not dispense this medication unless ordered by a healthcare provider and an “Administration of Medication Request” form is provided, along with a container of the medicine. Please see the following requirements for a student to possess and self-administer non-prescription medication in each grade level.

Grades 5-6: 

A student in possession of a non-prescription medication should only have a one-day dosage and note from the parent explaining the medication and its use.  The non-prescription medication should be stored in the original marked container.  Also, medication should be in safe containers; that is, no glass, sharp objects, or such things that could be dangerous to themselves or others. Upon arrival at school, the student is to give the note explaining the medication and show the medication to the nurse/designated personnel in the clinic, where it is to be kept until needed. The medication will be sent home at the end of the day. 

Grades 7-8: 

A student in possession of a non-prescription medication should only have a one-day dosage and note from the parent explaining the medication and its use.  The non-prescription medication should be stored in the original marked container.  Also, medication should be in safe containers; that is, no glass, sharp objects, or such things that could be dangerous to themselves or others.  Upon arrival at school the student is to give the note explaining the medication and show the medication to the nurse/designated personnel in the clinic. The parent note will be copied and kept in the clinic, the student can then self-carry and self-administer the non-prescription medication.  No such medication should be given to other students. 

Grades 9-12: 

A student in possession of a non-prescription medication should only have a one-day dosage and note from the parent explaining the medication and its use.  The non-prescription medication should be stored in the original marked container.  Also, medication should be in safe containers; that is, no glass, sharp objects, or such things that could be dangerous to themselves or others. No such medication should be given to other students. 

Immunizations

In order to safeguard the school community from the spread of certain communicable diseases and in recognition that prevention is a means of combating the spread of disease, the Board requires all students to be immunized against poliomyelitis, rubeola (measles), diphtheria, rubella (German measles), mumps, pertussis (whooping cough), tetanus, hepatitis B, varicella (chickenpox), and meningococcal in accordance with state statutes, unless specifically exempt for medical or other reasons. Required immunizations prior to entering school:

Kindergarten and All Students

• DTaP- 4 doses required- 5th dose required if 4th dose is given before 4th birthday

• Polio- 3 doses required; 4th dose required if 3rd dose is given before 4th birthday

• Measles/Mumps/Rubella (MMR)- 2 doses required; 1st dose must be given after child’s 1st birthday

• Hepatitis B- 3 doses required, 4th dose may be required if minimum intervals are not met.

• Varicella- 2 doses required; 1st dose must be given after child’s 1st birthday

7th Grade

• A Tdap dose is required on or after the 10th birthday, prior to entry of 7th grade

• Meningococcal (MCV4)- 1 dose required on or after the 10th birthday, prior to entry of 7th grade

12th Grade

• Meningococcal (MCV4)- Booster dose required on or after the 16th birthday, prior to entry of 12th grade (If the first dose was given on or after the 16th birthday, only one dose is required)
  
  

Students who do not have evidence of proper immunization will be excluded from school after

fourteen (14) days, in accordance with Ohio Revised Code sections 3313.67 and 3313.671.

For the full list of vaccine requirements please go to: 

Ohio Department of Health Immunization Requirements

If your student will not be receiving vaccines for medical reasons or you have reason to object to the vaccination, please complete the attached form and return it to the school office.  

Immunization Exemption Form

Guidelines for How Long to Keep a Sick Child Home from School

To Stay or To Go: Guidelines for How Long to Keep a Sick Child Home from School

It is sometimes difficult to decide when and how long to keep an ill child home from school. The following are guidelines for some of the more common childhood illnesses and our usual recommendations. It is always a good idea to contact your physician for specific diagnosis and

treatment. Please keep these guidelines available for future reference.

Chicken Pox— This is a skin rash that progresses to blisters, then scabs. A slight fever may or may not be present. Your child should remain home until the sixth day after onset of rash or until all lesions are dry.

COVID-19 (SARS-CoV-2)- Symptoms can include fever or chills, cough, shortness of breath or difficulty breathing, fatigue, muscle or body aches, headache, new loss of taste or smell, sore throat, congestion or runny nose, nausea or vomiting, diarrhea. This list does not include all possible symptoms. If your child has a positive test or signs and symptoms consistent with

COVID-19 he/she should stay home until cleared by the local health department.

Fever—If your child’s temperature is 100 degrees Fahrenheit or greater (or 1-2 degrees above the child’s normal temperature) he/she should remain home until fever free for 24 hours, without the use of fever reducing medication (i.e. Tylenol, Advil).

Flu—Symptoms of the flu include abrupt onset of fever, chills, headache, and sore muscles. Runny nose, sore throat, and cough are also common. Your child should remain home from school until symptoms diminish and your child is fever free for 24 hours, without the use of fever reducing medication.

Head Lice—Lice are small wingless insects that lay eggs called nits. Nits firmly attach to the hair shafts near the scalp. They are small white specks and are commonly found at the nape of the neck and behind the ears. Following lice infestation, your child may return to school after receiving treatment with a pediculicide shampoo and he/she has been cleared by the health clinic

staff.

Impetigo—This consists of blister-like, pus-filled bumps that later develop into yellowish, crusted sores that are commonly found around the nose and mouth. Your child should remain home from school until 24 hours after starting an effective antibiotic and all sores are dry, or can be covered at all times.

Pain—If your child complains or behavior indicates that he/she is experiencing persistent pain, he/she should be evaluated by a physician before being sent to school.

Pink Eye—Redness and swelling of the white(s) of the eyes or inside the eyelids, discharge from the eyes, itchy or scratchy eyes, or crusting of the eyelids or lashes may be present. Your child should remain home from school until 24 hours after starting an effective antibiotic.

Ringworm—Symptoms may include a scaly, itchy, red circular bald spot on the scalp. Skin may have a red, itchy, ring-like rash. Your child should remain home until 24 hours after an effective treatment is started.

Skin Rashes—Skin rashes of unknown origin should be evaluated by a physician and the diagnosis reported to the office before your child is sent to school.

Strep Throat & Scarlet Fever—Strep throat symptoms can consist of fever and red throat with pus spots. With scarlet fever, there are all of the symptoms of Strep throat, as well as a strawberry appearance of the tongue and a sandpaper-like rash on skin and inside of the mouth. High fever, nausea, and vomiting may also occur. Your child should remain home from school until receiving 24 hours of antibiotic therapy and has been fever free and without vomiting for 24 hours.

Vomiting and Diarrhea (Intestinal Viral Infections) - Stomach ache, cramping, nausea, vomiting, and diarrhea are often present, along with a possible fever, headache, and body aches. Your child should remain home until he/she has been without vomiting, diarrhea, or fever for 24 hours, without the use of fever reducing medication.

*Derived from the Ohio Department of Health Communicable Disease Chart

Screenings

Marysville Exempted School District provides vision and hearing screenings in the following grades:

-Vision in grades K-1-3-5-7-9-11

-Hearing in grades K-1-3-5-7-9-11

Screenings can be provided at times other than those listed above, if requested. Questions about the screening procedures should be directed to the Health Consultant/Clinic Aide at your student's school. Parents/Guardians who wish to have their children excluded from screenings may do so by completing a waiver form.

Vision Screening Monitoring Waiver

Hearing Screening Monitoring Waiver