Health Room Request

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Health Room Request

Please get permission from your teacher before filling out a request to see the nurse.

Please note that between 11:00 and 12:30 during lunch hours the health room is very busy with students coming for scheduled medications and procedures. If you request to visit the health room during this time, you may experience a wait. I promise to get to your request as soon as possible. If it is an urgent matter, your teacher will call and let me know. Please do not send in multiple request.

* the health room does not keep allergy medications, cold medications or cough drops on hand for students.

*no medication will be administered before 9:00 am or after 2:15 pm unless it is ordered by a doctor.

Please READ the nurse form, if it is filled out incorrectly I will not locate you to call you.

Email *

Record my email address with my response

Name (first and last) *

What teacher and room number are you in? *

Why do you need to see the nurse? *

Headache - Try eating and drinking before submitting nurse form

Stomach Ache - Try eating, drinking and using the bathroom before submitting nurse form

Feminine Issue

Sneezing, coughing, congestion, stuffy nose - We do not have anything for allergies, cough/cough drops, and cold. We can check for a fever otherwise drink lots of water

Sore throat - We can check for fever/check throat otherwise drink lots of water

Other:

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