School Health

Forms

School Health

School Health Forms

Emergency Health Plans
If your child has a health condition that may require emergency treatment at school, please fill out an Emergency Health Plan for the condition listed below. If you do not see your child's specific condition or feel the health plan is not what you would like followed at school, please contact your school nurse.
Asthma
Severe Allergy
Seizure

Health History Forms
If you child has a health condition, health history forms aid the school nurse in providing the best care for your child. Please fill out the below forms, if applicable to your child's health condition.
Diabetes Medical Management Form
Allergic Reaction History Form
Seizure Health History Form

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 medication guidelines and consent form click here:
Medication Administration Form-English
Medication Administration Form-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

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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.

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Please click on one of the categories below to see uploaded documents.
Contact Information
Department of Public Works
Engineering Division
Menasha City Center 
100 Main Street, Suite 200 
Menasha, WI 54952
 
Phone: 920-967-3610
Fax: 920-967-5272

Office Hours:

Monday - Friday
8:00 am - 4:00 pm

Public Works Director:
Adam Alix e-mail

Deputy Director of Engineering:
Corey Gordon e-mail

Administrative Assistant:
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