NOTE FROM NURSE BETH:

Dear parents, 

I look forward to working with you in the upcoming 2022/23 school year at Westerman Preschool! In the meantime, I want to give parents a “heads up” about things that must be done if your student has any medical needs.  If your student does not have any medical needs, please disregard this letter.

A lot of this information may look daunting, but I just wanted to be as thorough as possible so that you have as much time as possible to get things squared away.  If you have questions about these things, the nurse will work with you closer to the beginning of the school year. 

The safety and well-being of your student is paramount to all of us.  There are several diagnoses for which we require certain forms, doctors’ notes, and medication to be kept on the premises.  Please see examples of different diagnoses in the following pages.  

Please note that students cannot start school without these forms and medication.  It is best to begin calling their doctors’ offices now to be sure you have everything in order well before the first day of school. 

I know that the lists of things we need may look intimidating, but doctors’ offices in the area are familiar with the types of forms that Ann Arbor Public Schools need. These are the same requirements for all students in the district at all grade levels. 

Severe Allergies (food, bee stings, etc.) 

If your student has any type of severe allergies to foods, bug bites, latex, or anything else, there are some forms and medications we will need to have at the school in the event your student has a mild or severe allergic reaction. This does not include seasonal allergies. 

What we need: 

1. Allergy Action Plan - this must be given to you by and signed by a healthcare provider, such as an MD, NP, or PA. This is a document that gives clear instructions on what to do in certain situations where a student may be having an allergic reaction. Most offices have their own standardized versions of this, but if they do not, they may use this one. 

2. Documentation of allergens - we must have a clear list of your child’s allergens from a healthcare provider. They may just be included in their Allergy Action Plan, which is fine. 

3. Medication Administration Form - please have this form filled out by the healthcare provider. Please make sure to sign the bottom portion as well. This gives us permission to administer the medication. You can find the form here. 

4. Medications - please make sure to have these medications ready before the start of school! They must be in their original boxes with prescription labels still attached. Be sure that they aren’t due to expire during the school year. 

a. Epinephrine injectors - If your child is prescribed an epinephrine injector (Epi-Pen, AuviQ), we must have a set of two to be kept exclusively at the school. b. Benadryl - the Benadryl must be in liquid form and must be the correct dosage (typically the doctor orders children’s Benadryl). Must be unopened and still in the box. The Benadryl does not need to be prescription. 

c. Albuterol inhaler - If your student also has asthma or is prescribed an inhaler for allergic reactions, we will also need one for school. 

i. Spacer / chamber - if your child is prescribed an inhaler, we must also have a spacer / chamber to be kept at school in case we need to use it. 

Important notes: 

We will need a copy of each form either emailed as a file (a PDF or a scanned image), or sent in on paper accompanying the medication. We will not accept photos of forms. 

We must have epinephrine injectors AND antihistamines (Benadryl or other) available at the school in the event of an allergic reaction. 

Your school nurse will call you toward the start of the next school year to go over your student’s health care plan and to determine if any special accommodations need to be made.

Asthma or Reactive Airway Disease 

If your student has ever been diagnosed with either of the above conditions, we MUST have an inhaler (and spacer, if ordered) for them that can just be kept at the school. If your student was diagnosed with asthma as a baby and has not had an episode in several years, do not assume that the diagnosis is resolved! Instead, ask their doctor about this. It’s important to have a rescue inhaler at home and at school in case they have an unexpected asthma attack.

What we need: 

1. Asthma Action Plan - this must come from and be signed by a healthcare provider (an MD, Nurse Practitioner, or a Physician’s Assistant - this should not be signed by an RN). Doctors’ offices in the area are familiar with this type of form and likely have their own standardized Action Plan that they use. It will note when to use an inhaler, when to call 911, etc. 

2. Medication Administration Form - please have this form filled out by the healthcare provider. Please make sure to sign the bottom portion as well. This gives us permission to administer the inhaler as needed. You can find the form here. 

3. Inhaler and spacer to be kept at school - If your child has asthma or Reactive Airway Disease, then they are REQUIRED to have an inhaler to be kept at school. Ask their doctor to prescribe a second inhaler AND SPACER / CHAMBER to be kept exclusively at school. This must be kept in its original box with the prescription label still attached. Please check the expiration date on the inhaler and make sure it is not due to expire during the school year. 

Important notes: 

We will need a copy of each form either emailed as a file (a PDF or a scanned image), or sent in on paper accompanying the medication. We will not accept photos of forms. 

If we do not have an inhaler for your child and they are having serious asthma symptoms, we will call 9-1-1. 

Because of COVID (this may change in the future), we are not able to administer nebulizer treatments at school, because it is an aerosolizing procedure. If your child has an asthma attack, we will follow the Asthma Action Plan. If the nurse determines that your student still needs a nebulizing treatment at home, we will call the parent. 

A preschool-aged child MUST have a spacer and/or mask to be used with their inhaler. Without the spacer, a child this young will not be able to get a full dose of medication. Please ask your child’s doctor to prescribe a second one for school use.

Your school nurse will call you toward the start of the next school year to go over your student’s health care plan and to determine any special accommodations that need be made, if any. 

Seizure disorders / Epilepsy 

If your student has ever been diagnosed with a seizure disorder (either absence or generalized seizures) or epilepsy, we MUST have their emergency seizure medication that can just be kept at school. 

What we need: 

1. Seizure Action Plan or Doctor’s order- this must come from and be signed by a healthcare provider (an MD, Nurse Practitioner, or a Physician’s Assistant - this should not be signed by an RN). They may have a standardized Action Plan that they use, or they may just write it out as a medication order and also fill out the Medication Administration Form (below). The doctor’s order must read the name of the medication, when to give it, what dosage, and what route of administration. 

2. Medication Administration Form - please have this form filled out by the healthcare provider. Please make sure to sign the bottom portion as well. This gives us permission to administer the medication as needed. You can find the form here. 

3. Emergency medication to be kept at school - If your child has been prescribed emergency seizure medications (e.g, rectal diazepam or intranasal Versed), then they certainly should have another dose or set to be kept at school. This must be kept in its original box with the prescription label still attached. Please check the expiration date on the medication and make sure it is not due to expire during the school year. 

4. List of current medications - If your student has a diagnosed seizure disorder, they may also take medications at home daily (e.g., Keppra, phenobarbital, etc.). We will need to know that your student is taking this daily, as there are some side effects that are important for your child’s teachers and other staff to be aware of. 

Important notes: 

We will need a copy of each form either emailed as a file (a PDF or a scanned image), or sent in on paper accompanying the medication. We will not accept photos of forms. 

Emergency seizure medications are considered controlled substances. For this reason, this medication should never be sent into school in a child’s backpack. It must be brought in by a parent, counted, and signed in by authorized staff prior to or on the first day of school. Please coordinate with your school’s nurse prior to the first day of school. 

Your school nurse will call you toward the start of the next school year to go over your student’s health care plan and to determine any special accommodations that need be made, if any. 

ADHD (if taking medication)

If your student has been diagnosed with ADHD and is required to take daily medication, please work with your child’s prescribing provider to develop a schedule that avoids their having to take medication during school hours - if at all possible. 

If that is not possible and your child must take their medication during school hours, please see below.

What we need: 

1. Medication Administration Form - please have this form filled out by the healthcare provider. Please make sure to sign the bottom portion as well. This gives us permission to administer the medication as needed. You can find the form here. 

3. A prescription-labeled bottle of medication to be kept at school - This must be kept in its original bottle with the prescription label still attached. The dosage on the bottle must match the dosage ordered on the Medication Administration Form. This must be brought in by a parent.

4. List of current medications - If your student is taking multiple doses of ADHD medications per day, or multiple different medications, please inform the nurse. We will need to know what your student is taking daily, as there are some side effects that are important for the nurse to be aware of. 

Important notes: 

We will need a copy of each form either emailed as a file (a PDF or a scanned image), or sent in on paper accompanying the medication. We will not accept photos of forms. 

Most ADHD medications are considered controlled substances. For this reason, this medication should never be sent into school in a child’s backpack. It must be brought in by a parent, counted, and signed in by authorized staff prior to or on the first day of school. Please coordinate with your school’s nurse prior to the first day of school. 

If your child’s medication changes (the medication type, the dosage, or the time of administration), please talk with the nurse.  We will need a new form from their doctor each time a medication changes. Your child’s medication may change often over the first few years as they try to find the most ideal and effective treatment. The nurse is here to support these changes!

Your school nurse will call you toward the start of the next school year to go over your student’s health care plan and to determine any special accommodations that need be made, if any. 

Complex medical needs - 

If your child has complex medical needs - for example, if your student has diagnosed Type 1 diabetes, is fed via a g-tube, has any cardiac diagnoses or surgical history, has any notable congenital diagnoses or chromosomal abnormalities - then we will discuss these things with you closer to the start of the school year.  

If your child has complex medical needs, we will discuss whether they need an Individualized Health Plan (IHP) before school begins.

There are different forms needed for different diagnoses, so we will talk about this as soon as a nurse is back in the district in the weeks prior to the start of school.

There are some complex medical needs for which your nurse may request medical records from their medical group or primary care physician. Please be aware of this - the idea is to have the fullest picture of your child’s complex medical needs to better facilitate a positive (and safe!) learning environment.