Health Services

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Click the links below to download the following forms.

Student Health Information Form

Request for Administration of Prescription Medication

Request for Administration of Non-Prescription Medication 

Immunization Forms 

Student Immunization Law

Where to get Immunizations 

Physician Ordered Procedure Forms

Generic Procedure Form

Mechanical Suctioning Form

Ostomy Care

Oxygen Administration

Tracheostomy Care

Tube Feedings

Urinary Catheterization

Medical Statement for Special Dietary Needs

Completed forms can be emailed to Aramark at dietitian@rusd.org or mailed to: Racine Unified School District, C/O Aramark, ATTN: Dietitian, 2333 Northwestern Ave, Racine, WI 53404.

A Medical Statement for Special Dietary needs must be complete and on file with the dietitian before accommodations are made.  We are required to provide accommodations for special dietary needs based on a qualifying disability if the medical statement is completed and signed by a state-authorized medical authority.

All medical statements that are signed by a state-authorized medical authority that does not have a qualifying disability, will be accommodated at the District's discretion.  We will do our best to ensure that your child receives a safe and nutritious meal that fits his/her specific dietary needs while meeting meal pattern requirements.

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