South Kingstown High School
School Nurse Teacher Contact Information:
Mrs. Rachel Guidera, MSN, RN, CSNT
Rguidera@sksd-ri.net
401-360-1021 (Office)
401-360-1464 (Fax)
Welcome to the SKHS Nurse Informational Site! You can access any district forms that may pertain to your student. If you have any additional questions or concerns, please don't hesitate to contact me!
Authorization to Administer Prescription and
Non-Prescription Medication and Medication Policy
*All medication requires both a physician's order and this SKSD authorization form.
*All prescription medication must come in the original prescription-labeled containers with the student's name, date of birth, and prescription orders that match the written order.
*Medications in the school setting are only administered by a Registered Nurse.
*If any student were to self-carry any medication, prescription or non-prescription, a physician order is required specifying this.
SKSD Emergency Health Care Plan
for Bee Stings, Severe Food Allergy, or Specific Allergen
*This form must be filled out and signed by a physician for any student with a bee sting and/or a severe food allergy.
*Please take note of the bottom of this document where it requests if the student is authorized to self-medicate themselves during an off-site school-sponsored activity.
*Please communicate with the school nurse if the emergency medication will be self carried by the student (This also requires a physician order).
State of RI School Physical Form
*A (third) health examination is required upon entry to the twelfth (12th) grade. This health examination must be performed after the student turns sixteen (16) years of age, and no later than six (6) months after the student enters the twelfth (12th) grade.
South Kingstown School Department Health Requirements
9th Grade HPV Requirement
A student entering 9th grade must have met the 8th grade immunization requirements, plus:
3 doses of HPV (human papillomavirus) vaccine *Note: Per current ACIP recommendations, 2 doses of HPV (human papillomavirus) vaccine (if series is started at age 14 or younger)
No student should be excluded from school if he/she is not vaccinated against HPV, however, if the child is not going to receive the vaccine series, an exemption form must be completed.
12th Grade MCV Requirement
A student entering 12th grade must have met the 9th-grade immunization requirements, plus:
1 dose of Meningococcal Conjugate (MCV4) vaccine - booster dose
If you'd like to fill out an exemption form for any of the immunizations, please refer to the links below.
Asthma Action Plan
*This form will act as a physician's order to manage your student's asthma diagnosis. It must be filled out and signed by a physician annually in order for it to be valid in your student's health record.
*Please note the check boxes at the top of the page regarding authorizing student's to self carry and self administer their inhalers*
Athletic Trainer Webpage
Assumption of Risk Athletic Form
Release of Information and Consent Form