Dear NCA family, 

I am the School Nurse at North Cedar Academy (NCA) and I look forward to meeting your child. My first and foremost concern is the health and well-being of our students, staff, and the Ladysmith community. 

You must complete all the necessary health forms in the attached medical packet to ensure your child’s health in an illness or emergency. Please complete the following forms and return them to NCA before your child’s arrival this fall. This gives me time to review the records and ensure they are complete with the necessary information. It is important to include any allergies, medications, nutrition/dietary restrictions, health concerns, and any recent surgeries. Include any dental or mental health issues. We at NCA follow confidentiality protocol closely. 

The following forms need to be completed and returned to NCA: 

1. NCA Student and Parent Information 

2. Student Medical Information 

3. Authorization of Non-prescription Medication(s) 

4. Standing Orders for Medication Administration 

5. Authorization of Prescription Medication(s) 

6. Marshfield Medical Center: Release of Information Authorization 

7. Marshfield Medical Center: Consent to Treatment of Minors 

8. Prevea: Hospital Authorization to Communicate Health & Billing Information to Designated Persons 

9. Prevea: Health Request for Medical Care 

10. Prevea: Authorization for Disclosure of Health Information 

Immunization records are extremely important. The State of Wisconsin has mandated laws that state students attending private and public schools must have on file the required vaccines to maintain compliance in the State of Wisconsin.

If you choose to waive (refuse) immunizations due to health, religious, or personal convictions, you must indicate on the Student Immunization Record – Step 4 which vaccines you are waiving and then provide your signature and date.

A physician must sign and date the form if the waiver is due to health reasons. I have included the following immunization forms and guidelines: 

11. Rusk County Public Health Vaccination Information and Vaccine Requirements 

12. Student Immunization Record 

13. Wisconsin Immunization Registry Vaccine Administration Record 

Please note if a student has incomplete immunizations, the student may be excluded from classes if an outbreak occurs.

If you have any questions, please contact me at NCA: +1 715 532 0201 x 230 or ckrings@northcedar.net.

Wishing you a healthy and safe year! 

Sincerely, 

Cynthia A. Krings RN, BSN 

School Nurse
North Cedar Academy
Email: ckrings@northcedar.net
Phone: 715.532.0201 X230

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Download New Student Medical Packet

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