Nurse Forms
 
Nurse - Trisha Modeen MSN RN PEL-CSN
Office Phone - (815) 431-2461
Office Fax      - (815) 431-3350
  

Student Exemptions Begin October 16th, 2017 for any student who remain non-compliant in any area mentioned below:

Parents: Click on the links on the left hand side of page to print a copy of Health forms for your Physician.

9th Grade Requirements:
1. 9th Grade Physical/Immunization Form
2. Health History Form

10th Grade Requirements:
1. Health History Form
2. Sports Physical if participating in any Sports Team.  Immunizations must be up to date.
        **Immunization Records can be viewed in Family Web Access Account**

11th Grade Requirements:
1. Health History Form
2. Sports Physical if participating on any Sports Team.  Immunizations must be up to date.
   **Immunization Records can be viewed in your Family Web Access Account**

12th Grade Requirements:
1. Health History Form
2. Meningococcal Vaccine - 2nd MCV Dose required at the Start of Senior Year or after turning 16 years of age.  One dose required if received after age 16.
3. Sports Physical if participating on a Sports Team.  Immunizations must be up to date.
  **Immunization Records can be viewed in your Family Web Access Account**


Parents - Click on the links on the left hand side of page to print a copy of Health forms for your Physician.

End of Year Medication Pick Up

It is the parent/guardian’s responsibility to pick the medication/Epi-Pens/Diabetic Supplies/Nebulizer Equipment up by the last day of school.  Students will not be allowed to pick this m
edication up, it will only be released to the parent/guardian.  The last day of student attendance for the 2017-2018 school year will be May 25th, 2018.  All medication left in the Nursing Office after May 25th will be destroyed.  If you are unable to pick up the medication by May 25th please contact Trisha Modeen, RN PEL-CSN (School Nurse), at (815) 431-2461 by May 25th, 2018 to make different arrangements.  
If your student will continue the use of medication/Epi-Pens/Diabetic Supplies/Inhaler/Nebulizer Equipment for the 2017-2018 school year, you will be required to complete new forms and have the student’s physician sign approval forms.  These forms will be required before any medication is left in the Nurse’s office. Parent permission and MD Permission forms are located on the OTHS Website under Parent Resources in the “Nurse Office” link.  You may also stop by the Nursing Office, room 205, to discuss your student’s health needs with Trisha Modeen, RN, and pick the forms up.
If you have any questions please contact Mrs. Modeen at (815) 431-2461.

Nurse - Trisha Modeen MSN RN PEL-CSN
Office Phone - (815) 431-2461
Office Fax      - (815) 431-3350