Vision Screening Forms
Information for Parents/Guardians
The WCSD maturation program will be offered to all 5th grade students. This is an opt-in program. The boys and girls will be separated. The material will be presented by the district nurses. Parents are welcome to attend.
Please call the district nurse call phone (453-395-8219) with any questions.
Student Self-Administration of Asthma, Diabetes Medication or an Epinephrine Auto-injector
- A. The student’s parent or guardian signs a statement authorizing the student to self- administer asthma or diabetes medication or an epinephrine auto-injector; and acknowledging that the student is responsible for, and capable of, self-administering the asthma or diabetes medication , or an epinephrine auto-injector
- B. The student’s health care provider signs the appropriate form authorizing student to self-administer, including the name of the medication, indicating it is medically appropriate for the student to self-administer asthma, diabetes medication, or an epinephrine autoinjector and be in possession of the asthma, diabetes medication and supplies, or the epinephrine auto-injector at all times.
- C. Any misuse of asthma, diabetes medication and supplies, or the epinephrine auto- injector by the student may subject the student to disciplinary action under the District’s Safe School Policy and state law.
- Please refer to our medication administration policy, found on this page under Resources, for further information.
Student Self-Administration of Other Medication
Students grade 5 to grade 12 may carry his/her own temporary prescription and non-prescription medication to school in appropriate labeled containers in instances where the student’s maturity level is such that he/she could reasonably be expected to appropriately administer the medication on his/her own. In such instances, the student may carry one day’s dosage of prescription or nonprescription medication, excluding all controlled substances, on their person.
If your student has a health concern that may impact his or her learning, please notify your school health aide in order to determine if a school health plan is appropriate. Standard health plans, lunchroom accommodations, and transportation forms can be found on the Health Services site under Health Care Plans. It is the parent/guardian responsibility to inform the school of all medical concerns.
The WCSD nurses will conduct vision screenings for grades pre K, K, 1, 2, 3, 5, 7, 9, special education students, new students and referrals. The results of the vision screening may be shared with other educators and healthcare professionals to provide appropriate services. If your student does not pass the screening, a letter will be sent home. Please inform your school health aide if you do not want your child to participate in the screening. You will need to fill out and submit the opt-out form (found on this page under Resources) to your students teacher.
If you are in need of financial assistance in order to see an optometrist, please contact your school health office. The district has some financial assistance options available.