Fairbanks Local School District

If your child is diagnosed with one of the following chronic health conditions please complete the packet and return to the nurse at the beginning of each school year or upon diagnosis.

Each packet includes a parent questionnaire, release of information form, guidelines for medication reference, and specific medication authorization forms for each condition.

Allergy Packet

Asthma Packet

Diabetes Packet

Seizure Packet

A student requiring prescription medication at school must have a completed prescription medication authorization form on file in the school office. This form must be completed by both the physician who prescribes the medication and the parent/guardian of the student prior to school staff being permitted to administer the medication. If there are any changes to the medication (dose, discontinuation, etc) a new form must be completed and signed by the physician and parent/guardian and turned into the school office.

Prescription Medication Authorization

Authorization for Asthma Medication (includes self-carry option)

Authorization for Epinephrine Auto Injector- Self Carry

The school will provide Tylenol/Acetaminophen, Advil/Ibuprofen, Tums, and cough drops, however the brand, form (pill, liquid, chewable tablet), and flavor will be based on availability. If you prefer your child to have a specific brand, form (pill, liquid, or chewable tablet), flavor or if your child requires dye free medication we ask that you provide that medication to the school in its original packaging with the seal intact and labeled with your child/children’s names. If you will be providing the medication a parent/guardian must bring it in.

Prior to any medication being administered to your child/children a phone call will be made to discuss symptoms and consent for administration. If staff is unable to reach the parent/guardian no over the counter medication will be given. To ensure the safety and well being of your child we must receive verbal consent directly from a parent/guardian unless other arrangements have previously been put in place.

Authorization for Administration of Over the Counter Medication

Fairbanks Local Schools want our school community to be a healthy place to learn. Childhood vaccines help safeguard children and adolescents against preventable disease in school buildings where the potential for disease transmission could be higher. 

Ohio law requires students to be up-to-date on specific childhood vaccines and parents must provide Fairbanks Local Schools with a copy of the student’s immunization record. The State of Ohio allows a 14-day period after entering school for parents to submit proof of immunizations to the School Nurse. If you have any questions or concerns about immunization requirements please call and ask to speak to the school nurse.

Students who do not have evidence of proper immunization or an exemption form on file will be excluded from school after 14 days, in accordance with Ohio Revised Code sections 3313.67 and 3313.671.

Required immunizations prior to entering school:

• Kindergarten and All Students

  • DTaP- 4 doses required- 5th dose required if 4th dose is given before 4th birthday

  • Polio- 3 doses required; 4th dose required if 3rd dose is given before 4th birthday

  • Measles/Mumps/Rubella (MMR)- 2 doses required; 1st dose must be given after child’s 1st birthday

  • Hepatitis B- 3 doses required, 4th dose may be required if minimum intervals are not met.

  • Varicella- 2 doses required; 1st dose must be given after child’s 1st birthday

• 7th Grade

  • A Tdap dose is required on or after the 10th birthday, prior to entry of 7th grade

  • Meningococcal (MCV4)- 1 dose required on or after the 10th birthday, prior to entry of 7th grade

• 12th Grade

  • Meningococcal (MCV4)- Booster dose required on or after the 16th birthday, prior to entry of 12th grade (If the first dose was given on or after the 16th birthday, only one dose is required)

For the full list of vaccine requirements please go to:

Ohio Department of Health Immunization Requirements

If your student will not be receiving vaccines for medical reasons or you have reason to object to vaccinations please complete the Immunization Exemption Form and return it to the school nurse.

Health Assessment, Screening, and Referral Information

The health screening is the school nurse's way of checking students for possible health problems that might interfere with the child's classroom performance. Screenings may include the child's health history, parent and teacher observations and the nurse's professional evaluation. The school nurse will make a referral if any concerns are identified.

When and what health screenings will be done on my child at school?

Ohio law 3313.69 requires school nurses to conduct periodic health screenings. Screenings will be conducted on all new students to the district and at the following grade levels:

Hearing: K-1-3-5-7-9-11

Vision; K-1-3-5-7-9-11

If you wish to exclude your child from the health screenings please complete Hearing and Vision Screening Waiver