- Pequot Lakes Public Schools
- Health Services
Medical Authorization Forms
- Authorization for the Release of Medical Information
- Medication Policy
- Eagle View Medication Administration Form
- Eagle View Acetaminophen and Ibuprofen Authorization
- MS/HS Medication Administration Form
- MS/HS Acetaminophen and Ibuprofen Authorization
- Allergy / Anaphylaxis Action Plan
- Asthma Action Plan
- Seizure Action Plan
Health Services
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Welcome to the Pequot Lakes School District's Health Services webpage. The health services team collaborates with parents, healthcare providers, educational services, and the community to promote student health so students can meet their educational goals.
The mission of the health services department is to support students and staff in promoting health practices and limiting the effects of health conditions. We strive to meet the students’ physical, social, and emotional health needs and the health/safety of the entire school community while promoting an environment that supports student health and limits barriers to learning.
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Medications at School
Parents/guardians and healthcare providers are responsible for providing any needed medications, including over-the-counter medications like Tylenol or Advil. The school does not provide any "stock" medication or treatments, including ointments. All medications should be administered at home under the supervision of the parent/guardian whenever possible; however, when students require administration of medications during the regular school day, the following procedures will be followed:
Parents/guardians must bring the medication to the school in the original bottle with the original pharmacy label. School personnel will not dispense medications that are sent to school in improperly labeled containers (ie. plastic bags or containers, envelopes, etc.)
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A signed order from a licensed medical prescriber to administer the medication at school, also signed by the parent/guardian. The label and the order need to match exactly. Our nurses are licensed and cannot dispense any medication or provide any treatments without a healthcare provider order and a parent or legal guardian authorization. (A parent/guardian signature will be accepted for standard Acetaminophen or Ibuprofen ONLY.)
- If the parent/guardian is unable to bring the medication to school, they should contact the school health office to arrange a transport method prior to sending in the medication, and also note the quantity of the medication being sent.
- Controlled medications cannot be self-administered and must be brought directly to the health office and counted with a parent/guardian when initiated and/or refilled.
Before accepting or administering ANY medication (including over-the-counter), the school health office must receive a signed authorization from the student's licensed health care provider and from the parent/guardian. (Parent/guardian signatures will be accepted for standard Acetaminophen and Ibuprofen administration only.)
We accept original or faxed copies of a prescriber's order on their order forms or letterhead. Parental permission may be added to the prescriber's form. Authorization must include:
- Student Name
- Date
- Name of Medicine
- Dosage
- Time of day it is to be taken
- Duration of time it is to be taken
- Licensed health care provider signature
- Parent/Guardian signature
For students with specific health concerns (seizure disorders, asthma, anaphylaxis), the medication authorization can also be completed on an emergency care plan. We accept emergency care plans from the health care provider or you can use one of the forms in the Quick Links to the left.
Medication authorizations are required at the start of EACH school year and automatically expire at the end of that school year. Students are allowed to carry their inhalers and EpiPens with the healthcare provider and parent/guardian authorization.
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Sharing of Medication is Strictly Prohibited
Students may not share prescription or over-the-counter medications with family or other students.
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Unused Medications
When the use of a medication has been discontinued or is no longer needed by the student, the parent/guardian must make arrangements to pick up unused medications from the school. Parents/guardians will receive a reminder that their student has medication left in the health office. The school does not dispose of unused or expired medications. Medications cannot be kept in the health office over the summer with the intent of using them the next school year.
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Medication Changes or Termination
It is the responsibility of the parent/guardian to notify the school health office when a medication changes or if the medication is discontinued. Any changes in dosing must come with a signature from the licensed health care provider.
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Field Trips
Health office staff do not routinely accompany students on field trips. Prior to leaving the building, health office staff, teachers, parents/guardians, and students share the responsibility of communicating health issues that may need to be addressed while on the field trip.
If medication is needed during the time of the field trip, another district employee will be designated to assume this responsibility after receiving appropriate medication administration instructions. Field trips that take place outside of the school day, including overnight field trips, will follow the same procedure.
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Cell Phone Usage
No phones are allowed to be used in the health office unless there is a component needed for medical treatment such as a glucose sensor or insulin pump. When a student comes into the health office, it is expected that they will put their cell phone either in their backpack or on the counter during their time in the health office. They may take it out if asked to call or text parents/guardians only. No photos/videos/social media usage in the health office. (This is a privacy issue and if a student is in violation, they will be referred to the office staff.)
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General Health Information
Your student should stay home if they are not feeling well enough to attend classes, if they have a cough that is not contained, and if they have a communicable disease such as chickenpox, strep throat, or influenza. Please notify your student's building health office if they are diagnosed with a communicable disease. If you are uncertain, please contact your building nurse.
If your student has vomited or had more than one episode of diarrhea, they are required to stay home for the rest of the day or until after vomiting and diarrhea have passed.
Your student must stay home for a fever of 100 degrees Fahrenheit or greater, and your student must stay at home for a minimum of 24 hours after the fever is gone without taking fever-reducing medications.
Health Services Staff
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Tracy Princivalli RN, PHN, LSNDistrict Nurse218-568-9575
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Kim Syd LPNMiddle School / High School
Phone: 218-568-9207Fax: 218-568-4680
ksyd@isd186.orgOffice Hours: 7:45 a.m. - 3:15 p.m. -
Ann Sweeney LPN
Eagle View Elementary
Phone: 218-562-6105Fax: 218-562-6106Office Hours: 7:45 a.m. - 3:15 p.m.