Nurse Practitioner services will be provided by Ashly Ellis, FNP who has been with the students for the last several years. Items that your child/ren will be able to utilize the clinic for will include:

• Wellness visits including annual examinations and sports physicals.

• Urgent Care services for acute illness, injury with on-site testing available for Strep A, Covid, Influenza and UTI.

• Primary care appointments

Zaagigi Nurse Practitioner Consent

Sports Physical Forms: Both forms must be completed prior to your appointment and parental signature in place, or you will be rescheduled.

MHSAA Physical Exam/Medical History Form

Bay Mills Health Center Sports Physical Consent

The School Wellness program is grant funded and pairs a Registered Nurse and licensed mental health therapist to provide clinical services, referrals and health education. Rayann Basawa, RN and Jade Seelye, LMSW are within the school to support students physical and mental health. Some examples of services that your child/ren will be able to utilize with this program include:

• Screening/nursing assessment of general health established by the medical director, standards of care, and age-appropriate prevention guidelines.

• Provision of interventions for minor injuries, illness, chronic illness, medication administration per standing order.

• Mental Health Care.

School Wellness Program Consent

Medication Consent: It is required for any prescription medication as well as over the counter medication that is not on our standing orders. This form must be completed by parent and prescribing provider to be valid.

Medication Consent Form

Diabetic Forms: If your child is a Type 1 Diabetic, they will need to have a diabetic action plan completed by their provider. If they self-manage, then they will need the self-manage consent form completed. There will also be a Diabetes Emergency Response Plan for Hyperglycemia and Hypoglycemia that needs to be completed.

Diabetes Action Plan

Diabetes Self-Management Consent

Diabetes Hyperglycemia Emergency Action Plan

Diabetes Hypoglycemia Emergency Action Plan

Asthma Forms: We require students to have a medication consent for completed as above as well as an Asthma Emergency Action Plan.

Asthma Emergency Action Plan

Anaphylaxis Action Plan: We require students to have a medication consent form completed located above as well as an Allergy Emergency Action Plan.

Anaphylaxis Emergency Action Plan