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PHS School Nurse

If you have any questions or concerns, please reach out to Nurse Cheryl.

Health-Related Forms & Documents

Asthma Action Plan

AsthmaActionPlan.pdf 381.57 KB (Last Modified on April 25, 2022)

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Diabetes: Glucometer Testing

Glucometer Testing Letter.pdf 137.82 KB (Last Modified on April 25, 2022)

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Diabetes: Order and Care Plan

CI 13 Diabetes Order and Care Plan 9.2020_final.pdf 325.07 KB (Last Modified on April 25, 2022)

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Diet Order

CMS Diet Order 2024 updated.pdf 44.01 KB (Last Modified on December 9, 2024)

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Health Assessment Transmittal Form ENGLISH (ver2016)

HAForm2016.pdf 39 KB (Last Modified on April 25, 2022)

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Health Assessment Transmittal Form SPANISH (ver2016)

HATransmittalformParentSecSpanish.pdf 215.51 KB (Last Modified on April 25, 2022)

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Immunization Requirements (SPANISH)

NC School Vaccine Checklist SPA.jpg 1.47 MB (Last Modified on July 12, 2023)

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Medication and Self-carry Authorization Form

Med 01 Medication Authorization Forms 5.2024.pdf 217.81 KB (Last Modified on September 4, 2024)

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Seizures: Diastat MD Order

Diastat_MD_Order.pdf 234.69 KB (Last Modified on May 6, 2022)

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Seizures: Emergency Action Plan

CI 21 Seizure EAP and Medication Order 10.2022 Revision.pdf 485.68 KB (Last Modified on October 24, 2022)

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Severe Allergy: CMS Diet Order 2019

CMS Diet Order 2019.pdf 348.48 KB (Last Modified on April 25, 2022)

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Severe Allergy: Emergency Action Plan

Severe Allergy EAP 8 2017.pdf 349.39 KB (Last Modified on April 25, 2022)

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Sickle Cell: Emergency Action Plan

CI25SickleCellEAP7-09.pdf 96.13 KB (Last Modified on April 25, 2022)

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Contact Info

Mecklenburg County Health Department School Health Nurse

Email Nurse Cheryl Cunningham

School: 980-343-5390
Cell: 704-562-0341
Fax: 980-343-3956

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