COVID-19  Student Medical Mask Waiver

Effective July 30, 2021, the StrongSchoolsNC Public Health Toolkit (K-12) stated that all students and staff should wear a face covering while at school and require a face covering on the school bus. Iredell-Statesville Board of Education voted on August 31, 2021, to mandate masks for all students and staff while indoors.  On September 7, 2021, the board voted to accept only those exemptions requests to the face covering requirement that are required by law and to require medical documentation from an appropriate medical professional for a student or staff member’s requests for medical exemption to the face covering requirement.

In cases where the superintendent mandates masks for specific groups, this document waives that requirement.

Some students cannot tolerate a cloth face covering due to developmental, medical, or behavioral health needs. If your child is unable to wear a cloth face covering due to conditions previously mentioned, please provide a signed medical waiver.  Give the waiver to the school nurse assigned to your child's school.  If you choose to provide the waiver via email, send to kkerley@iss.k12.nc.us.

Student Name: ________________________        School: _____________________________

The student listed above is a patient in my practice, and they are unable to wear a face covering to school due to a developmental, medical or behavioral health need. Please check the appropriate statement below and sign the form.

________ The student is able to wear a face shield, but unable to wear a face covering.

________ The student is able to wear a face covering for short periods of time, but should not

wear a face covering for periods lasting longer than _____ minutes/hours. When not

wearing a face covering, the student should be able to wear a shield.

________ The student is unable to wear a face covering or a face shield.

   ________________________________                                _______________

     Medical Provider Signature                                        Date                                

This form must be completed and turned in to the school nurse.