In order to assure the health and safety of your child at school, please complete the following questionnaire to assist us in identifying any health needs your child may have. This should also serve as a tool for you to identify forms that are required to be on file with Pine Lake each academic year. Forms should be completed in cooperation with your child’s physician and returned to the nurses, Rebecca Long and/or Alex Larson, by the first day of school each academic year. Forms are also required for non-prescription medication administration, and Potassium Iodide administration in the event of a nuclear emergency.

Please note all needed forms may be accessed via pinelakeprep.org or may be obtained from the school nurse. On pinelakeprep.org, from the Home Page, click on the “Family Quick Links” tab. From the menu, choose “Health Forms”. For questions or further information please contact Rebecca Long, RN at rebecca.long@pinelakeprep.org.