School Health

Protocols and Forms

School Health

School Health Protocols and Forms

School Health Protocols
If your child has a health condition that may require emergency treatment at school, please fill out an emergency protocol for the condition listed below. If you do not see your child's specific condition or feel the protocol is not what you would like followed at school, please contact your school nurse.

Medication Consent Form
Administration of medication requires both the signature of a parent and the physician on the consent form. A new consent form is required each time a medication or dosage is changed.
For complete medication administration guidelines click here:
Medication Administration Guidelines-English
Medication Administration Guidelines-Spanish

Immunization Forms
State law requires all public and private school students to present written evidence of immunization against certain diseases within 30 days of admission. 
Student Immunization Form-English
Student Immunization Form-Spanish

Doc app

Document Center

The Document Center provides easy access to public documents. Click on one of the categories below to see related documents or use the search function.

Search for file type:
Categories always sorted by seq (sub-categories sorted within each category)
Documents sorted by HEADER in Ascending Order within category
Please click on one of the categories below to see uploaded documents.
CAT:354
Download File
document Header Asthma
file:356
Download File
document Header Bee Sting Allergy - Life Threatening
file:357
Download File
document Header Bee Sting Allergy - Non Life Threatening
file:358
Download File
document Header Diabetic Emergency Protocol
file:362
Download File
document Header Diabetic Medical Management Plan
file:363
Download File
document Header Food Allergy - Life Threatening
file:364
Download File
document Header Food Allergy - Non Life Threatening
file:365
Download File
document Header Food Allergy Health History
file:366
Download File
document Header Latex Allergy - Life Threatening
file:368
Download File
document Header Latex Allergy - Non Life Threatening
file:369
Download File
document Header Nosebleed
file:374
Download File
document Header Seizure (Absense-Partial)
file:354
Download File
document Header Seizure (Convulsive)
file:359
Download File
document Header Seizure (DIASTAT)
file:376
Download File
document Header Seizure Health History
file:375
Download File
document Header Shunt Malfunction WITH History of Seizure
file:377
Download File
document Header Shunt Malfunction Without Seizure
file:378
Medication Consent Form 2 documents
CAT:404
Download File
document Header Medication Consent Form - English
file:429
Download File
document Header Medication Consent Form - Spanish
file:428
School Health Protocols 17 documents
CAT:405
Download File
document Header Asthma
file:430
Download File
document Header Bee Sting - Life Threatening
file:431
Download File
document Header Bee Sting - Non life Threatening
file:433
Download File
document Header Diabetic Emergency Protocol
file:434
Download File
document Header Diabetic Medical Management Plan
file:448
Download File
document Header Food Allergy - Life Threatening
file:435
Download File
document Header Food Allergy - Non Life Threatening
file:437
Download File
document Header Food Allergy Health History
file:447
Download File
document Header Latex Allergy - Life Threatening
file:436
Download File
document Header Latex Allergy - Non Life Threatening
file:438
Download File
document Header Nose Bleed
file:439
Download File
document Header Seizure (Absence or Partial)
file:440
Download File
document Header Seizure (Convulsive) Protocol
file:443
Download File
document Header Seizure (DIASTAT)
file:449
Download File
document Header Seizure Health History
file:422
Download File
document Header Shunt with History of Seizure
file:444
Download File
document Header Shunt without History of Seizure
file:445
Contact Information
City Clerk 
Menasha City Center
100 Main Street, Suite 200
Menasha, Wisconsin 54952

Phone: 920-967-3608
Fax: 920-967-5273
 
Office Hours:
Monday - Friday
8:00 a.m. - 4:00 p.m.
 
City Clerk 
Debbie Galeazzi email
 
Deputy Clerk 
Stephanie Cheslock  email
Category Events