Health Services

Marcia Stewart

Districtwide Health Coordinator:
Phone: 614-835-2017
Email Ms. Stewart

Two girls washing their hands and smiling

Before the start of each school year, please be sure to contact your school nurse and child’s teacher to discuss any health concerns your child has, including severe allergies, seizures, diabetes, asthma, and current medication. During the school year, please be sure to update the school nurse and teacher about any new or changing medical conditions or medication.

Health Service Forms

Administering Nonprescription Medications
This form is to request the administration of non-prescription or over-the-counter (OTC) medications to your child.
Authorization for the Possession and Use of an Epinephrine Autoinjector
This form authorizes the possession and use of an epinephrine autoinjector by a student.
Food Allergy and Anaphylaxis Emergency Care Plan
FARE's Food Allergy & Anaphylaxis Emergency Care Plan, formerly the Food Allergy Action Plan, outlines recommended treatment in case of an allergic reaction, is signed by a physician and includes emergency contact information.
Immunization Requirements for Students Entering Grade 12
This form documents that a student entering grade 12 has received the recommended immunizations.
Immunization Requirements for Students Entering Grade 12-Nepali
ग्रेड 12 मा प्रवेश गन􀅑 िव􀈨ाथ􀅎ह􀅝का लािग प्रितर􀆗ण खोपका आव􀊴कताह􀅝
Immunization Requirements for Students Entering Grade 7
This form documents that students entering grade 7 have received the required immunizations.
Immunization Requirements for Students Entering Grade 7-Nepali
ग्रेड 7 मा प्रवेश गन􀅑 िव􀈨ाथ􀅎ह􀅝का लािग प्रितर􀆗ण खोपका आव􀊴कताह􀅝
Ohio Legal Immunization Exemption
This form is to notify Pickerington Schools that a student is not in compliance with immunization recommendations. This form must be completely filled out and submitted with supporting documentation.
Physical Exam Form
For new students enrolling into kindergarten or grade 1. Please have your child’s health care provider complete this form and return it to your child’s assigned school building. Your child will not be cleared to attend school until this form has been signed and returned to the school on or before August 1.
Plan de Atención de Emergencias de Alergias Alimentarias y Anafilaxia
Request for Administration of Prescription Medication by School Personnel Grades K-12
This form is to request the administration of prescription medication. It must be signed by your child's health care provider.
Request for Specialized Health Care Services - Parent Authorization
The Parent Authorization Form must accompany the Physician Authorization form.
Request for Specialized Health Care Services - Physician Authorization
Physician Authorization must accompany Parent Authorization.