Leckie School Nurse
DC Universal Health Certificate [dchealth.dc.gov] - Annual Form providing updates on the child's physical health status and updated immunizations. Pages 2-4 must be filled out by a medical professional.
School Health Services Program - [enrolldcps.dc.gov] Review of programs, policies, and procedures for receiving health suite services. Aimed at creating a deeper understanding of health suite protocol and consent for students to receive screenings including vision, dental, and hearing as needed.
School Health Telehealth Program Consent Form [enrolldcps.dc.gov] - Consent for your child to receive telehealth care from Children's School Services AKA Childrens National Hospital.
Consent to Share Student Health Education Records [enrolldcps.dc.gov] - Consent for nurses to share educational health records with key DCPS staff to better provide for the needs of your child.
Immunization Requirements [dchealth.dc.gov]- Informational list of required immunizations by DC Health for all school-age children
Immunization Opt-out Information [dchealth.dc.gov]- Information for religious or medical exemptions with details on applying and submitting
DC Health Oral Health Assessment Form [dchealth.dc.gov] - Report oral health status or information on the most recent visit
School-Based Oral Health Program Consent Form [dchealth.dc.gov] - Consent to the annual DCPS school-based oral health program. Each year a Dentist comes to Leckie and provides dental screenings and services to students during school
Medical Plan/ Procedure Form [dchealth.dc.gov] - Outlines student needs for medication and or. a medical procedure plan
Asthma Action Plan [dchealth.dc.gov] - Outlines a student's asthma needs, severity, triggers, and action plan for treatment
Anaphylaxis Action Plan [dchealth.dc.gov] - Outline a plan if your student has an allergic reaction that may require an epi pen
Medical Dietary Accommodation Form [enrolldcps.dc.gov] - If your student requires a special meal plan, related to a medical condition or food allergy, this form must be completed and emailed to DCPS Food and Nutrition Services (FNS) at: email@example.com. A new form must be submitted each time a dietary change is requested.
Milk Substitution & Philosophical Dietary Accommodations Form [enrolldcps.dc.gov]- If your student requires a milk substitution related to lactose intolerance or requires a special meal related to religious/philosophical food preferences, this form must be completed and emailed to DCPS Food and Nutrition Services (FNS) at: firstname.lastname@example.org.