STUDENT HEALTH RECORD

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EMERGENCY CARD

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Health & Safety

Hawaii Keiki Forms
 

Dear Parents/Guardians,

Did you know that Central Middle School has added a Nurse to your school health room to work with the School Health Assistant (SHA) in supporting your child’s health and education? Central Middle School is staffed with a Hawaii Keiki advanced practice registered nurse (APRN). When your child is sick at school, this APRN can treat your child and decide—if your child needs to go home or can stay in school.
 

The APRN can:
* Care for your child’s allergies, asthma, and other medical conditions.
* Give your child medication when needed.
* Offer advice about health topics to you and your children.
 

Why is this important? Because keeping your child in school keeps them in class, which keeps them learning.
 

There’s no cost to you for any services your child may receive. However, we need your insurance information in case we need to bill them for certain services. Students without health insurance can still get care from the APRN at no cost.
 

But before a Hawaii Keiki APRN can care for your child, we need your permission. Please review the enclosed consent form, sign it, and return it to Cortney Crocker, APRN.
 

Remember that a Hawaii Keiki APRN doesn’t replace the care your child gets from the doctor or clinic.
 

Also, even though you’ve signed the consent form, we won’t treat or give medications to your child without talking to a parent or guardian first.
 

If you have any questions about the consent form or the Hawaii Keiki APRN, please contact Cortney Crocker.
 

Thank you for keeping your child healthy and learning!

Cortney Crocker

Hawaii Keiki Consent Form

UCERA TCS Form