Health Information

School Nurse - South                                         Health Room Aide - North
Kristi Kirk, RN                                                      Paula Nordwig (AM)    Michel Kaliebe (PM)
Phone 262-369-3630                                         Phone 262-369-3628
E-mail kirk@arrowheadschools.org                         E-mail nordwig@arrowheadschools.org  

Welcome to Arrowhead. My name is Kristi Kirk and I am the RN. If you have any health questions or concerns, please give me a call at 369-3630. Arrowhead has a health room at each campus. I staff the south campus all day and aides Paula Nordwig and Michel Kaliebe staff the north campus from 7:00 a.m. – 3:00 p.m. 

Students are not allowed to carry any over-the-counter or prescription medications at AHS. All medications are dispensed from the health room after the medication forms are completed, which can be printed below.  The only exception is after their physician fills out an individual health plan for inhalers, EPI-Pens, and insulin pens, the forms can be printed below.

Forms required for all freshman and new students: 

• Immunization Record –  Required by the State of Wisconsin - State statute ss.252.04 and 120.12. (16). Please fill out completely or attach a copy of the student's immunizations from their physician's office and sign. The State of Wisconsin has added two immunizations that are required before freshman and senior year.
  • TdaP (tetanus, diphtheria and acellular pertussis) vaccine. The only exception is if the student received a tetanus containing vaccine (e.g. Td vaccine) within 5 years of entering the 9th and 12th grade.  That student is considered compliant and a TdaP booster dose is not required.
  • Varicella (chickenpox) vaccine: A second dose will be required for students entering 12th grade or documentation of the year they had chickenpox disease

•  History & Physical Physician Form
  • The parents complete the top section of the form, which contains emergency numbers and emergency contacts. It is very important to keep these emergency numbers up to date, as we will not release any student without permission from parents or the emergency contact that you designated. 
  • The bottom section of the form needs to be completed by a physician. All freshmen/new students are required to have this physical form completed. If your child will participate in sports, a green WIAA physical card will also be required. Take both forms (the history & physician physical form and the green physical card) to the doctor for signature.

• Over The Counter Medication Consent Form - This form is required for students to receive any medication from the health room. Three medications are stocked in the health room: acetaminophen (Tylenol), ibuprofen (Advil), and diphenhydramine hydrochloride (generic Benadryl). All other medications must be brought and stored in the health room. 

Prescription Medication Authorization

Prescription Medication Consent Form - Required only if prescription medication will be administered at AHS.  This form must be completed by the parents and signed by the prescibing physician every year that daily medications will be administered at AHS. This form is also necessary for administation of temporary prescriptions such as antibiotics, pain medications, etc.

Individual Health Plans:

• Allergic Reactions Individualized Health Plan - Any student who has an EPI-PEN must have a completed Allergic Reactions Individualized Health Plan. Parents fill out the top section and a physician must sign the bottom section.

• Asthma Individual Health Plan - Students with asthma must have a completed Asthma Individual Health Plan. Parents fill out the top section and a physician must sign the bottom section.

• Seizure Disorder Health Plan - Students with a seizure disorder must have a completed Seizure Disorder Health Plan signed by a parent.

• All students with diabetes are encouraged to store extra supplies and snacks in the health room cabinet and refrigerator.  Please make an appointment each year with their endocrinologist. Below are the documents all diabetics need at Arrowhead High School annually.
  • Emergency Action Plan – Parents to fill out
  • Hyperglycemia Quick Reference Emergency Plan – Parents to fill out
  • Diabetic Medical Management Plan - Parents and MD to complete. Physicians can also use their own forms. CHW uses a form called Diabetic Individual Health Plan.  Students are allowed to self-administer & self-dose insulin outside of the health room at Arrowhead only when their physician has documented that the student can self-administer and self-dose insulin on the Diabetic Medical Management Plan. The parent and student then sign the Self Administer and Self Dose Insulin Outside The Health Room form which can be printed below.
  • Self Administer and Self Dose Insulin Outside The Health Room – Must be signed by parents and students.