Liberty Pines Academy Health Clinic
Clinic Hours: 7:30 am-3:30 pm
Clinic Phone:(904)-547-7919, Fax: (904) 547-7905, District COVID Team at 904-547-8230.
Please feel free to email us directly with any questions or concerns, or with any updates regarding your child’s health status: [email protected]
Medication Forms for
2022-2023 School Year
- Medication Policy
- Note: The School must have new medication forms or medical management plans on file EACH school year.
- RX Medication Authorization Form
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If your student requires prescription medication to be kept in the school clinic, this form must be completed and signed by the physician and the parent/guardian.
(Note: ALL prescription medications must singed into the clinic by a parent/guardian. Students can only carry: Inhalers, EpiPen/Auvi-Q auto-injectors, pancreatic enzymes, and emergency Glucagon with physician authorization. Students found in possession of medications without the proper paperwork on file will be subject to disciplinary action as noted in the Student Code of Conduct. - Self Carry Form
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Non-prescription medication may be carried with Middle and High School students with this signed permission form filled out by a parent and student. Medication MUST be kept in original bottle. Please have student bring form to clinic so a copy can be kept on file at the school.
WHEN TO KEEP MY CHILD HOME?
Deciding when to keep your child home from school can be difficult. Please follow the recommended two step guidelines below…….
DOES MY CHILD HAVE TWO OR MORE OF THE FOLLOWING?
- Chills
- Muscle aches
- Headache
- Sore throat
- New decrease in smell or taste
- Vomiting and/or diarrhea
DOES MY CHILD HAVE ONE OR MORE OF THE FOLLOWING SYMTPOMS ?
- Fever of 100.4 or higher
- Uncontrolled cough
- Shortness of breath
Any “YES” answers = your student should stay home. Please contact your child’s health care provider and email your child’s teacher. Symptom criteria from the Florida Chapter of the American Academy of Pediatrics states students who meet the screening criteria above will be sent home for further medical evaluation.
