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Licensed prescriber’s name
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Pharmacy name, address, and phone number
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Name or initials of pharmacist
Prescription medication found in a student’s locker or on the student’s person will be considered in violation of the school’s regulations
concerning drugs and will be confiscated, excluding inhalers and Epi-Pens used by asthmatics.
Over the counter medications (OTC) will be distributed only through the Student Health Center with parental consent.
Students will be responsible at the end of the treatment regime for removing any unused medication from the school. If the medication
is not picked up by the end of the school year, it will be disposed of and documented that the medications were discarded. Medications
will be discarded in the presence of a witness.
IMMUNIZATION, HEALTH, EYE, AND DENTAL EXAMINATIONS
Required Health Examinations and Immunizations
All students are required to present appropriate proof of a health examination and the immunizations against, and screenings for,
preventable communicable diseases within one year prior to:
1.
Entering in ninth or twelfth grade; and
2.
Enrolling in an Illinois school for the first time, regardless of the student’s grade.
Failure to comply with the above requirements at the time of registration will result in the student’s exclusion from school until the
required health forms are presented to the school, subject to certain exceptions.
Eye Examination
All students entering an Illinois school for the first time must present proof by October 15 of the current school year of an eye
examination performed within one year. Failure to present proof by October 15, allows the school to hold the student’s report card until
the student presents: (1) proof of a completed eye examination, or (2) that an eye examination will take place within 60 days after
October 15.
Exemptions
A student will be exempted from the above requirements for:
1.
Medical grounds if the student’s parent/guardian and primary care physician present to the building principal a signed statement
explaining the objection;
2.
Religious grounds if the student’s parent/guardian presents to the building principal a completed Certificate of Religious
Exemption; this document must be signed by the student’s primary care provider
3.
Health examination or immunization requirements on medical grounds if a physician provides written verification;
4.
Eye examination requirement if the student’s parent/guardian shows an undue burden or lack or access to a physician licensed
to practice medicine in all of its branches who provides eye examinations or a licensed optometrist; or
5.
Dental examination requirement if the student’s parent/guardian shows an undue burden or a lack of access to a dentist.
SELF-ADMINISTRATION OF MEDICATION
A student may possess an epinephrine auto-injector (EpiPen®) and/or medication prescribed for asthma for immediate use at the
student’s discretion, provided the student’s parent/guardian has completed and signed a “School Medication Authorization Form.”
Pontiac Township High School District 90 shall incur no liability, except for willful and wanton conduct, as a result of any injury arising
from a student’s self-administration of medication or epinephrine auto-injector or the storage of any medication by school personnel. A
student’s parent/guardian must indemnify and hold harmless the Pontiac Township High School District 90 and its employees and
agents, against any claims, except a claim based on willful and wanton conduct, arising out of a student’s self-administration of an
epinephrine auto-injector and/or medication, or the storage of any medication by school personnel.
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