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Health Services

Student Health Services

Supporting student wellness to promote learning, safety, and success.

The vision of the Student Health Services team is that all students will be successful in their school environment. To achieve this vision, our mission is to support the physical, mental, emotional, and social health of students by preventing, removing, and reducing health-related barriers that interfere with learning and development.

Health Forms & Resources
Immunization Requirements

View the Wisconsin Department of Health Services immunization requirements for students attending school.

View Document

Student Immunization Record (DHS F-04020L)

Download and complete the official Wisconsin DHS immunization record.

Open Form

Medications at School (Authorization Form)

Authorization required for any medication administered at school.

Open Form

Medication Self-Carry Agreement (High School)

Permission for eligible high school students to self-carry approved meds.

Open Form

Kindergarten Eye Health Examination Report

Eye exam documentation for incoming kindergarten students.

Open Form

Medical Statement for Special Dietary Needs

Use this form to request meal accommodations for medical dietary needs.

Open Form

Medical Form for Outside of School Hours Trips

Health information and permissions required for off-hour school trips.

Open Form

Injury Reporting Form

Use this form to report student injuries that occur at school or during school-sponsored activities.

Open Form

When To Keep Your Child Home

Keeping our schools healthy helps reduce illness and ensure all students can learn safely. Please review the guidance below:

Stay Home When Sick

If your child is experiencing vomiting, diarrhea, or has a fever over 100°F, please keep them home. They may return to school 24 hours after the last symptom resolves without the use of medication.

Reportable Illnesses

If your child has a diagnosed reportable illness, as determined by the Wisconsin Department of Health Childhood Communicable Disease Chart, please contact your school nurse.

Stock Opioid Antagonist Plan

Outlines the district’s procedures for maintaining, storing, and administering opioid antagonist medication (e.g., Narcan) in cases of suspected opioid overdose.

View Plan

Stock Epinephrine Administration Plan

Describes the district’s guidelines for the storage and emergency use of epinephrine auto-injectors for severe allergic reactions (anaphylaxis).

View Plan

School Nurse Contacts

Tiphany Kokott

Tiphany Kokott

Elementary School Nurse

📧 Email

Angela Helget-Wedul

Angela Helget-Wedul

Middle School Nurse

📧 Email

Emily Hanes

Emily Hanes

High School Nurse

📧 Email

Questions?

Contact:

Jennifer Gimmer

Director of Safety and Student Services

📧 gimjen@holmen.k12.wi.us