Health Services

Health Forms (Please click the desired form below)

 Students with Allergies 

1. If your child has an allergy and requires the use of an Epi-pen for anaphylactic prevention, the Epi-Pen Form must be completed by the student's physician who prescribed the Epi-pen. 

     *The Epi-pen must be provided to the school in the original box with the prescription label.

     *If the student is in middle or high school, he/she may carry their Epi-pen on them. However, a backup Epi-Pen MUST be provided to the office. 

2. The Food Allergy Action Plan must be completed by the student's physician and returned to the office. 

3. If the student has a food allergy, your physician must complete the Medical Statement/ Food Allergy form so the cafeteria can make appropriate accommodations. 

Tips for Parents of Elementary Students:

1. Pack lunch for your child and have him/her sit at the buyer’s table. Although our Hilfiker kitchen (NOT middle or high school kitchen) is “peanut free” we cannot guarantee products were not manufactured in a peanut-free factory. Also, although we discourage parents from packing anything with peanuts for their children, it is not mandatory.

2. Provide a “Safe Snack Box” to your teacher. This container is to be filled with safe snacks/treats that your child is not at risk of reacting to. The purpose of this box is so your child will not feel left out when other classmates bring a treat to class. The teacher can pull a treat from the safe snack box avoiding any potential exposure.

3. Contact Mrs. Jeanne Brink, Food Service Supervisor, regarding your concerns so necessary accommodations can be made in the cafeteria. 419-637-7249

4. Take your child and introduce them to all his/her teachers (i.e. classroom teacher, elementary specials teachers: physical education- Ms. Diane Borys, music- Mr. Joe Kaiser, art- Ms. Marty Atkinson). Introducing your child will aid the faculty in being able to better identify your child and be familiar with his/her medical needs.

5. Have paperwork completed by a parent/guardian and physician so an epi-pen may be stored in the locked medicine cabinet in the nurse’s office.

6. Provide an Epi-pen to the school and school bus driver if your child rides the bus. Be sure the Epi-pen is in the box with the prescription label on the box.  Bus drivers are aware that Epi-pens are not to be stored on the bus as Epi-pens are temperature sensitive. 


Food Allergy and Anaphylaxis Network