You will find many links to forms on the Nature Coast Clinic page. Please read below for some FAQ information.
The Emergency Form is required by the HCSB to be on file and filled out annually. Please be sure to include the full names of any adult individuals who may pick your student up from Nature Coast on this form. We are not authorized to release to any individuals other than those listed, who present with proper identification. This form is returned to the school clinic.
Students signing out:
A student over the age of 18 may sign themselves out of school - depending on the circumstances this may be excused or unexcused.
A student who is of driving age, but not 18, can not be given permission to sign themselves out or leave school via a phone call or email.
The school must have a handwritten note specifying the student's name, date, and time they are to allowed to leave campus. The parent/guardian signature is then verified with the emergency card the school has on file. There are no exceptions to this.
Change of Address:
The change of address form is to be used when ONLY a change of physical address (or phone number) is needed versus the entire emergency form with who can pick a student up, etc...
A parent/guardian must sign this form as well as provide documentation of the new address. This can be done with a utility bill, lease, mortgage statement, driver's license of a parent, etc... that has the new address on it.
This form must be filled out by a health care practitioner and also signed (at the bottom) by a parent/guardian.
The name of medication, dose, time/frequency must all be included. The health care practitioner must print their name / address / phone number as well as sign and date the form.
This is to be used for non-prescription medication as well as prescribed medication.
A parent/guardian must bring the medication to the school as it is against school district policy for a student to be carrying medication of any kind.
Non-prescription medication must come in a new/sealed, unopened bottle/box/container and not be expired. A receipt will be given for all medication received by the clinic staff.
We require one form per medication.
School Immunizations /Physicals
It is a requirement that each student has a school health physical upon registration at a school as well as proof of immunizations (or certified exemption status from the Department of Health).
A school health physical is not required to be done each school year but one can always be turned into the clinic for filing. The exception to this is that an athletic physical IS required each school year for participation in athletics at Nature Coast. The athletic physicals are valid for 365 days from date of Physician signature.
Immunizations must be up to date and should be on a certified FL-680 form.
Temporary Medical Condition / PE - Sports
If your student has a temporary medical condition that places limitations on participation in a Physical Education class (HOPE-PE, Weight Training, Team Sports, etc...) please supply the clinic with a note from the treating Physician with the dates that the student is unable to participate and what the student's specific limitations are.
Students will still be required to "dress out" for their class as part of their grade unless specifically noted by Physician that this is not possible. Extra time will be allowed, if needed, to dress out.
Though many conditions are ongoing, requiring follow-up visits, we would request that the notes for limited participation span from one visit to the next.
For example if initial visit it March 1st and a follow up on March 14th; the note would be valid from 3/1 - 3/14 and another note obtained at March 14th visit.
Care plans are required for certain medical conditions and we have included all documents required for each care plan type. There is also a "generic" care plan for conditions that don't fit into another category.
Please return completed documents (be aware of all areas a Physician or parent/guardian needs to sign) to the Nature Coast Clinic. These documents may also be faxed directly to the clinic at 352-797-7099
Please find the links on the right side of the page for various care plans, authorizations for medications in school, emergency cards, change of address forms, and similar.
Please feel free to call the clinic at 352-797-7088 ext. 200 with any questions.
Our direct fax number is 352-797-7099, which goes directly to my email.
Ms. N. Pierce, CCMA
School Health Professional
CPR / First Aid site instructor
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