Request Nursing Support

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Please fill out the section below if you have a question or concern that one of our District School Nurses can help you with. Please note that this resource is not intended to replace the medical advice of a primary care provider, but only to support students and families in the school setting. If you think you may have a medical emergency, call your doctor, go to the emergency department, or call 911 immediately.

Your Name *

Relationship to Student *

I am the student

Parent/Guardian

Other:

Required

Student's First Name *

Student's Last Name *

School Site: *

Evergreen Elementary School

John Reed Elementary School

Lawrence Jones Middle School

Marguerite Hahn Elementary School

Monte Vista Elementary School

Rancho Cotate High School

Richard Crane Elementary School

Technology High School

Technology Middle School

Thomas Page Academy

University Elementary at La Fiesta

Required

I have a question for the school nurse about: (click one or all that apply)

Allergies/Epipen in the School Setting

Diabetes in the School Setting

Healthcare/Action Plan at School

IEP/504/SST

Immunizations

Lice/Nits

Medications at School

Vision/Hearing Screening

I have a question not listed above: (Please write your question below)

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