Immunization & Medical Information/Forms

posted by WPS Nurse Josh Trutna

Immunizations/Health Needs:

Immunization Requirements: Please click on the following link to access a summary of the 2023-2024 WPS rules and regulations for required immunizations: Immunization Rules & Regulations (Click HERE for the Spanish version)

Immunization Forms:
    Refusal of Immunization Form (for Medical Reasons)
    Refusal of Immunization Form (for Religious Reasons)

Medication/Treatment Form: Please click on the following link to access the WPS Medication/Treatment Form: Medication/Treatment Form

This form MUST be completed and returned to one of the school offices in order to give the school permission to administer any special health care treatments, procedures or medications (both prescription and over-the-counter) to your child.

Asthma/Allergy Action Plan: Please click on the following link to access the WPS Student Asthma/Allergy Action Plan (to be completed by both parent and physician): Ashthma/Allergy Action Plan

Physical Examination: Please click the following link to access the WPS Physical Examination Form: Physical Examination Form (Take this form with you to the physical appointment, have your physician complete and sign it, and return the form to one of the school offices)

Varicella (chickenpox): Please click on the following link to access the documentation of Varicella (chickenpox) disease form: Documentation of Varicella

These forms should be filled out by each student's parent(s), guardian(s), or medical provider and returned to any school office. Questions? Please contact WPS Nurse Josh Trutna (402-443-4250, ext. 1003, or email jtrutna@wahoowarriors.org).