Resources for School Nurses :: San Diego Unified School District

Nursing and Wellness > Resources for School Nurses

Resources for School Nurses

Parent Resources:

•	School Health Information
•	School Nurse Profile
•	Facts for Families (source: American Academy of Child & Adolescent Psychiatry)

Health Topics
Health & Medical Reference
Calendars & Schedules
Forms & Forms Notebook
Specialized Physical Health Care Procedures (SPHCS) Manual
Related Organizations

Health Topics

Immunizations

Health & Medical Reference

Calendars & Schedules

Forms & Forms Notebook

Swine Flu

Flu Symptoms - Parent Handout
English | Spanish | Cambodian | Somali | Tagalog | Vietnamese

Behavior Evaluation (PARD)

HE 805 — School Questionnaire: English
HE 1000 — HIPPA-Release of Information – Attention/Behavior: English | Spanish
HE 1001 — Parent Questionnaire: English | Spanish
HE 1002 — Parent Follow-Up Information: English | Spanish
HE 1004 — School Follow-Up Information
School Medical Referral for Behavior Evaluation

Anaphylaxis

Anaphylaxis Emergency Notebook
HE 490 — Emergency Medication Log
HE 801 — Authorization for use or disclosure of health information to and from schools: English | Spanish
Individualized School Healthcare Plan
Physician's Recommendations for Medication

Asthma

HE 220 — Asthma Action Plan: English | Spanish
HE 221 — Asthma Letter to Parents (Old Town/Balboa Park Programs): English | Spanish
HE 222 — Case Management Flow Sheet
HE 223 — Dear Doctor - Asthma Affecting Performance
HE 224 — Dear Parent - We've Missed Your Child at School!: English | Spanish

Attendance

HE 300 — Excessive Absence Due to Illness: English | Spanish
HE 301 — Excessive Absence Due to Illness - Second Notification: English | Spanish
HE 302 — Criteria For School Attendance for Health Reasons: English | Spanish

Beginning of School Year Forms

HE 643 — Request for Email Contact Person
HE 644 — Instructions for Substitute Nurse
HE 645 — Health Office Substitute Nurse Information
HE 646 — Ordering Forms
HE 647 — 2008-09 Program Planning Calendar
HE 648 — 2008-09 Nursing Activities Calendar
HE 650 — Frequently Used Resources

Child Abuse

HE 200 — Child Abuse - Annual Inservice Report
HE 201 — Suspected Child Abuse Reporting Instructions
Suspected Child Abuse Form: (PDF | Word )

Child Health and Disability Prevention (CHDP)

HE 900 — Program Procedure
HE 901 — Parent Notification Letter: English | Spanish
CHDP Eligibility Table (April 2009)
Report of Medical Examination for School Entry ("Green" form):
English | Spanish
School Entry Health Checkups (Parent Information)
English | Spanish
HE 902 — First Grade Exam Notice of Failure to Comply: English | Spanish
School Material Request Form
HE 903 — Notice of Exclusion from School Attendance: English | Spanish
HE 905 — First Grade CHDP Report
HE 906 — Kindergarten Mandated Cost Claim Report
HE 910 - CHDP/OHA Summary of Programs

Communicable Disease/Illness/Rash

HE 500 — Communicable Disease Information Log of Notices Sent Home
HE 501 — Communicable Disease Information: English | Spanish
HE 503 — Conjunctivitis Information: English | Spanish
HE 504 — Cytomegalovirus (C.M.V.) Infection
HE 505 — Diarrhea and Vomiting: English | Spanish
HE 506 — Facts About Fifth Disease (Erythema Infectiosum): English | Spanish
HE 507 — Hepatitis Fact Sheet: English | Spanish
HE 508 — Impetigo Fact Sheet: English | Spanish
HE 509 — Information on Meningococcal Disease for Sharing: English | Spanish
HE 510 — Information Sheet on Infectious Mononucleosis (Mono): English | Spanish
HE 511 — MRSA At School: English | Spanish
HE 512 — Mumps Information Fact Sheet: English | Spanish
HE 514 — Answering Parents' Questions About Colds, Flu, and When to Keep a Child Home: English | Spanish
HE 516 — Pinworms Fact Sheet: English | Spanish
HE 517 — Ringworm Fact Sheet: English | Spanish
HE 518 — Scabies Fact Sheet: English | Spanish

Consent Forms

HE 613 — HIPAA - Authorization for Release of Information: English | Spanish
HE 614 — Caregivers Authorization Affidavit: English | Spanish
HE 615 — Consent for Emergency Medical Treatment: English | Spanish
HE 616 — Motor Skills Assessment Permit: English | Spanish
HE 617 — Transportation Request and Consent: English | Spanish
HE 618 — Hepatitis B Virus Vaccine Consent

Dental

Happy Smile - Did You Know?
Happy Smile Evaluation Form
Happy Smile 2008-09 Fluoride Rinse Calendar
Happy Smile Instructions
Happy Smile Invitation
Happy Smile Permission Slip: English | Spanish
Happy Smile Toothbrush Contract: English | Spanish
Weekly Fluoride Instructions
22HO475 Dental Inspection
Oral Health Assessment (OHA)
- HE 910 - CHDP/OHA Summary of Programs
- HE 911 — Parent Letter:
  English | Spanish
- HE 912 - Oral Health Assessment / Waiver Request Form
  English | Spanish
- HE 913 - Oral Health Assessment Report Form: PDF | Word
- HE 914 Oral Health Assessment/Waiver Request Form Guidelines
- HE 915 — Parent Notification Letter:
  English | Spanish
- Dental Care Resources: ()
  San Diego County A-Z | Central County | East County | North County | South San Diego

Diabetes

HE 230 — Blood Glucose Testing - Algorithms for Blood Glucose Results
HE 231 — Information for Parents of Students with Diabetes
HE 232 — Blood Sugar Log: 2008-09
HE 233 — Diabetes Monitoring Log
HE 234 — Diabetes Monitoring Log for Insulin Pump
Diabetes Notebook (full contents)
HE 235 — Parent Consent and Physician Authorization: English | Spanish
HE 613 — HIPAA - Authorization for Release of Information: English | Spanish

Hearing

Clinic Appointment Application: English | Spanish
Audiometry Work Sheet
Hearing Test Appointment Application: English | Spanish

Hepatitis B / HIV

HE 540a — AIDS/HIV Communication Flow Chart - Employee
HE 251 — AIDS/HIV Communication Flow Chart - Student: English | Spanish
HE 252 — AIDS/HIV Consent for Disclosure - Student: English | Spanish
HE 253 — HIV/Hepatitis B - Annual Update to Staff
HE 254 — Disease Prevention Guidelines
HE 255 — Universal Precautions

Immunization

Immunization Clinics: English | Spanish
Required Immunization
HE 801 — Dear Doctor - Immunization Requirements
HE 802 — Exclusion List
HE 803 — Notice of Exclusion from School Attendance: English | Spanish
Notice of Failure to Comply: English | Spanish
HE 805 — Notice of Immunization Due: English | Spanish
HE 806 — Parent Questionnaire: History of Chicken Pox Disease
HE 808 — Protocol for Chicken Pox Evaluation
HE 810 — Tetanus Boosters in School for Contaminated Wounds

Injury, Emergency and other Related

HE 550 — Allergy to Latex
HE 551 — Anaphylaxis Emergency Protocol: Essential Steps
HE 552 — Bee Sting Local Reaction Protocol
HE 553 — Dental Emergency Procedures: English | Spanish
HE 554 — Bloodborne Disease Prevention: English | Spanish
HE 555 — First Aid Protocol
HE 556 — Fractures: Common Symptoms and First Aid
HE 557 — Guidelines for Jog/Walk-A-Thon
HE 558 — Head Injury - Parent Notification: English | Spanish
HE 559 — Heat Stroke Fact Sheet: English | Spanish
HE 560 — Heat Exhaustion Fact Sheet: English | Spanish
HE 561 — Heat Cramps Fact Sheet: English | Spanish
HE 562 — Human Bite Management in Schools
HE 563 — Post-Op Instructions for Schools
HE 564 — Proper Food Handling Techniques and Practices

Medications

HE 613 — Emergency Medication Log
Medication Log: 2008-09
OTC Medication Protocol
OTC Medication Log
Physician's Orders For OTC Medications (For School Nurse Use Only)
Physician's Recommendations for Medication
Preventative Directly Observed Therapy (DOT) Medication Log
Steps in School Medication Administration

Miscellaneous

HE 513 — Guidelines for Suspected Neurological Impairment
Confidential Nursing Notes
Health Office Daily Log - A | B
Nurse Availability: English | Spanish
Operation School Bell Recommendation Form
Refrigerator/Freezer - Temperature Recording Chart
Universal Precautions

Pediculosis

Communicable Disease Log: Pediculosis
Dear Doctor - Resistant Head Lice
Dear Parent - Notification of Lice in Classroom: English | Spanish
Dear Parent - Your Child Discovered to Have Pediculosis: English | Spanish
Dear Parent -Your Child May Return to Class
Dear Parent -Your Child Still Has Active Lice: English | Spanish
District Policy: English | Spanish
Instructions for Treatment: English | Spanish

Pregnancy Forms

Report Forms

Scoliosis

Dear Parent - Spinal Screening Program Referral/Follow-Up: English | Spanish
Dear Parent - Spinal Screening Program Notice: English | Spanish
Dear Parent - Spinal Screening Results: English | Spanish
Scoliosis Information Sheet: English | Spanish
Scoliosis Screening Report

Special Education

Clinical/Classroom Observation Data Sheet
Developmental History for the Adolescent: English | Spanish
Guidelines of Contract Care for Students with Exceptional Needs
Health and Developmental History for Special Ed Referrals: English | Spanish
Health Assessment Template
Health History Update: English | Spanish
Teacher Evaluation of Student Behavior

Tuberculosis (TB) Skin Test

Attachment to Medication Log for Directly Observed Therapy Chemoprophylaxsis - INH Toxicity Review
Preventative Directly Observed Therapy (DOT) Medication Log
Tuberculin Skin Test Informed Consent: English | Spanish
Tuberculin Skin Test Permission Form: English | Spanish
Tuberculin Skin Testing Schedule 2007-08
Tuberculin Skin Test Sign-in Sheet

Vision Forms

HE 410 — Rest Haven Glasses Fund Application: English & Spanish
HE 411 — Report of Color Perception Test: English | Spanish
HE 412 — Vision Screening Report: English | Spanish
Clinic Appointment Application: English | Spanish

Specialized Physical Health Care Procedures (SPHCS) Manual

Gastrostomy Tube

Seizure Management (DIASTAT & VNS)

Related Organizations