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Health Services


School Nurse – Koreen Harpel

MLHS Health Services requires the following forms be on file for each student:

  • Health Information Services form: This form provides a health status update on your child for the school year and is required to be completed annually.
  • Student Immunization Record form: This form is required by law to keep track of your child’s immunization status. Update this form if your student receives any new immunizations.
  • Authorization for Administration of Medication form: This form is required to permit any distribution of medication during the school day. Prescription medications will require a physician and parent signature.
  • Health Action Plans: An emergency care plan is needed for your child for any significant health concern (Asthma, Diabetes, Life-threatening Allergies, Seizures). To be completed by a medical provider (forms available below).

Medication Policy

The school does not provide any medication to students. In accordance with the MN Department of Health, the school will administer medications to students under these circumstances:

  • All medication must be in the original, labeled container. Prescription medications require both a parent/guardian and health care provider’s signature on the Authorization for Administration of Medication form.
  • Non-prescription medications require a parent/guardian’s signature on the Authorization for Administration of Medication form. Parent/guardians are encouraged to bring medication to the school office. If this is not possible, a parent/guardian should contact the school to set up an alternative plan.
  • Students are NOT allowed to carry or self-administer medications unless an exception is made and a written plan is agreed upon between the school office and the parent/guardian.
  • Students are allowed to carry an inhaler and/or Epi-pen when the following criteria have been met:
  • The school receives annual written permission from the student’s parent and health care provider to allow self-administration of the inhaler and/or Epi-pen.
  • The inhaler is properly labeled for the student.
  • Successful completion of an assessment of the student’s knowledge and skills to safely use and possess an inhaler in the school setting done by the school nurse.


According to MN Statute 121A.15, any student enrolled in an elementary or secondary school in Minnesota must be up-to-date with his/her immunizations. Failure to do so may result in exclusion from school. If you chose to conscientiously object, a notary signature is required on the Student Immunization Form

What immunizations does my child need? Download a schedule of required immunizations here.

Health Action Plans

If your child has a health condition that requires a specific action plan, download and complete the applicable form from below. You can also obtain a form from the nurse’s office or your clinic if your health condition form is not listed. Health Action Plans are required to be completed annually by your health care provider.
Asthma Action Plan
Severe Allergy Action Plan
Seizure Action Plan

Vision/Hearing Screening

Students will be screened in the 10th grade. If a student does not pass the initial screen, a re-screen will be performed by the school nurse. If the student fails the re-screen, a referral notice will be sent to the parent/guardian. If you do not wish to have your child screened, please contact the school office.

Student Illness & Attendance: To Send or Not to Send

A student should be excluded (and will be excused) from school with any of the following conditions: