Health Forms
School District of Howards Grove Health Services
Our goal is to help keep students healthy, safe, and ready to learn. Please review the information below and contact Nurse Lydia with any questions or changes to your child's health throughout the school year.
Medication at School
Whenever possible, medications should be taken at home. If your child needs medication during the school day, a completed Medication Authorization Form must be on file before any medication can be administered. Please see the medication authorization form for more information about our district’s medication policies.
All prescription and non-prescription medications require a completed authorization form: Medication Authorization Form
Emergency Health Conditions
Every student with an emergency health condition needs to have an emergency action plan (EAP) on file at school. Please fill out the following action plans if applicable, or have your child’s physician fax their EAP to 920-565-4458. Any health conditions that require emergency medications must have a medication authorization form filled out (see above).
Nurse Lydia will send invitations to families soon, offering an opportunity to meet with the school nurse and teaching staff to discuss any medical information or health needs that will help support their child's success and safety at school.
Immunizations
Look up your child’s immunizations on the Wisconsin Immunization Registry (WIR): Wisconsin Immunization Registry .. [Portal Main Page]
Here are the following immunization requirements for Wisconsin school-age children
Annual Health Update
Please update the school office with any of the following:
New diagnoses
Surgeries
Medications
Allergies
Hospitalizations
Yearly Health Screenings
Grade Levels Screened are Kindergarten, 1st Grade, and 3rd Grade. Additional screenings are available at any grade level upon referral by a parent/guardian, teacher, or school staff member.
Vision: The Howards Grove Lions Club partners with the district to provide vision screenings using the Spot Vision Screener, a quick, non-invasive device that helps detect potential vision concerns and identify students who may benefit from a comprehensive eye exam.
Hearing: The school nurse conducts hearing screenings using a pure-tone audiometer, measures a student's ability to hear sounds at different pitches and volumes, and an otoacoustic emissions (OAE) device, assesses how well the inner ear (cochlea) is functioning. These safe, quick, and non-invasive screenings help identify potential hearing concerns that may affect a student's learning and determine whether further evaluation by a hearing healthcare professional is recommended.
Health-Related School Board Policies
Immunization of Students in School ag5320
Physical Examination ag3160A
Administration of Medication/ Emergency Care po5330
Emergency Nursing Services po5310.01
Health Services po5310
Emergency Medical Authorization po5341
Wellness po8510
Pediculosis (Head Lice) po8451
Control of Casual-Contact Communicable Diseases po8450
Dental Resources
The School District of Howards Grove is proud to partner with Healthy Smiles LLC to provide a free, school-based dental sealant and fluoride varnish program for students. Licensed dental professionals visit our schools twice per school year to offer dental screenings, sealants, fluoride treatments, oral health education, and a toothbrush and toothpaste, all at no cost to families. Please complete the online consent form during registration, even if you choose not to have your child participate.
Contact Information
School Nurse: Lydia Pomeroy RN BSN
Office Phone: 920-565-4457
Cell Phone: 920-418-4922
Email: [email protected]





