In what grades do students need physicals and dentals?The Elkhorn Area School District requests student have a physical and dental exam when they enter the school district in 4k/5k or a new student and then in grades 4th, 7th, 9th. If participating in high school sports, a physical is required for 11th grade.
The Annual Student Health History forms for elementary, middle, high school are now provided during online registration. |
What other forms are needed?1. Immunization record are required for all students.
2. The EASD is required by Wis. Law to request an eye exam for all incoming kindergarten students 3. A health history form is requested each year. 4. Students who require prescription or parent-requested medication at school must have a prescription medication or non-prescription medication form completed each year. 5. Students who have chronic health conditions which require emergency medication (Epipen, Inhaler, Diastat, Glucagon, or insulin) at school must have an emergency action/health plan each year. 6. Students who have a health condition which requires nursing services will require a medical plan of care with physician's orders and a consent for release of information form each year. 
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Student Health Forms
Consentimiento para Emisión de Información
Non-Prescription Medicine Form
Prescription Medicine Form
Kindergarten Wisconsin Eye Exam Form
Diabetes Medical Management Form
Asthma Action Plan Form
Epipen Action Plan Form
Seizure Action Plan: /uploads/1/6/3/9/16396500/seizure_care_plan.docx
New Elementary Student and Kindergarten Health History Form
Elementary School Health History Form - Please complete this form online during registration.
Middle School Health Form - Please complete this form online during registration.
High School Health Form -Please complete this form online during registration.
Student Immunization Information
| elementary_school_physical_form_02.22.2017.pdf |
| ms_-_hs_student_physical_form.pdf |
| easd_dental_report_form.pdf |
| concussion_accommodation_orders_5_2016.pdf |
| consent_for_release_of_information_12_2015_-_google_docs.pdf |
When do I need a doctor's excuse?
Crutches & Wheelchair Doctor Excuses
Dental and Doctor Excuses for Physical Education:
Physical Education Excuses:
Wisconsin Stat. 118.15 (1) (c) states that students may be excused from a school program if a parent/guardian provides written evidence from a physician or licensed practitioners that the student is not in proper physical or mental condition. Such excuses shall state the period of time for which it is valid but not to exceed 30 days.
Recess, Field Trips, and Extracurricular Events:
Those students unable to fully participate in physical education will also be unable to participate in recess activities, field trips, and extracurricular events requiring physical activity. Students who have a doctor’s note allowing for partial activity in physical education will be allowed to participate in recess, field trips, and extracurricular events as activity indicates.
Resuming Activity:
School program limits due to breaks, sprains, or concussions require a doctor’s note to resume full activity.
Parent notes for PE:
Parents may write a note to excuse their child from physical education due to a parent identified illness or injury for 1 day while awaiting medical follow up or healing.
Slings, braces, crutches, or a wheelchair
Students who require the use of slings, braces, crutches, or a wheelchair due to an injury or surgery must have a physician's order stating limitations and restrictions. The doctor’s order must specifically include the use of crutches or a wheelchair during school. A doctor’s note is required to resume full activity in physical education or school programs.
Concussion: (Also see Concussion Tab)
Concussion: Wisconsin Stat.118.293(4)(a) states an athletic coach, or official involved in a youth athletic activity, or health care provider shall remove a person from the youth athletic activity if the coach, official, or health care provider determines that the person exhibits signs, symptoms, or behavior consistent with a concussion or head injury or the coach, official, or health care provider suspects the person has sustained a concussion or head injury. A person who has been removed from a youth athletic activity under par.(a) may not participate in a youth athletic activity until he or she is evaluated by a health care provider and receives a written clearance to participate in the activity from the health care provider. Wisconsin Stat.118.293(4)(b). Note: A licensed athletic trainer can clear students/athletes from a concussion.
Following a concussion, students must have a written release from a physician or a licensed athletic trainer indicating the student is able to fully participating in school academic activities prior to the student returning to physical education, recess, or extracurricular sporting events. See EASD policies on Return to Academics and Return to Play following a concussion.
Handicap parking is available at all school buildings for those students, family members, visitors and staff who have a temporary or permanent physical disability.
If you are an able-bodied person, please keep those parking areas open for those
that need them. Thank you!
Dental and Doctor Excuses for Physical Education:
Physical Education Excuses:
Wisconsin Stat. 118.15 (1) (c) states that students may be excused from a school program if a parent/guardian provides written evidence from a physician or licensed practitioners that the student is not in proper physical or mental condition. Such excuses shall state the period of time for which it is valid but not to exceed 30 days.
Recess, Field Trips, and Extracurricular Events:
Those students unable to fully participate in physical education will also be unable to participate in recess activities, field trips, and extracurricular events requiring physical activity. Students who have a doctor’s note allowing for partial activity in physical education will be allowed to participate in recess, field trips, and extracurricular events as activity indicates.
Resuming Activity:
School program limits due to breaks, sprains, or concussions require a doctor’s note to resume full activity.
Parent notes for PE:
Parents may write a note to excuse their child from physical education due to a parent identified illness or injury for 1 day while awaiting medical follow up or healing.
Slings, braces, crutches, or a wheelchair
Students who require the use of slings, braces, crutches, or a wheelchair due to an injury or surgery must have a physician's order stating limitations and restrictions. The doctor’s order must specifically include the use of crutches or a wheelchair during school. A doctor’s note is required to resume full activity in physical education or school programs.
Concussion: (Also see Concussion Tab)
Concussion: Wisconsin Stat.118.293(4)(a) states an athletic coach, or official involved in a youth athletic activity, or health care provider shall remove a person from the youth athletic activity if the coach, official, or health care provider determines that the person exhibits signs, symptoms, or behavior consistent with a concussion or head injury or the coach, official, or health care provider suspects the person has sustained a concussion or head injury. A person who has been removed from a youth athletic activity under par.(a) may not participate in a youth athletic activity until he or she is evaluated by a health care provider and receives a written clearance to participate in the activity from the health care provider. Wisconsin Stat.118.293(4)(b). Note: A licensed athletic trainer can clear students/athletes from a concussion.
Following a concussion, students must have a written release from a physician or a licensed athletic trainer indicating the student is able to fully participating in school academic activities prior to the student returning to physical education, recess, or extracurricular sporting events. See EASD policies on Return to Academics and Return to Play following a concussion.
Handicap parking is available at all school buildings for those students, family members, visitors and staff who have a temporary or permanent physical disability.
If you are an able-bodied person, please keep those parking areas open for those
that need them. Thank you!
