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Contact Information
LCMCISD: Little Cypress-Mauriceville High School
7327 Hwy 87 North
Orange, Texas 77632
Phone: 409.886.5821
Fax: 409.886.5762

LCM NURSING STAFF

Jeannie Alexander, RN

jalexander@lcmcisd.org

409-886-5821, Ext. 1170

Lisa Fuselier, LVN

lfuselier@lcmcisd.org

409-886-5821, Ext. 1171

Nurse Fax Number 409-670-4637

 

Click here for frequently asked health questions and district rules about visiting the school nurse.

FREQUENTLY USED FORMS 

Click on the name of the form to download and print the form.

Permission Form for Prescribed Medication:  If your student needs to receive any prescription medication while at school, this form needs to be filled out and signed by a parent and physician. The medication will be kept locked up in the nurse’s clinic. No medication can be kept on the student while at school.

Over the Counter Medication: If you want to send an over the counter medication for your student to use at school as needed, you need to send the medicine in an original labeled bottle with your student’s name on it. Please also send a parent note with your signature and phone number stating the student can receive the medicine at school with the dosage. We can’t administer more than the recommended dosage without a physician’s order.

Asthma Action Plan: If your student has been diagnosed with asthma, this action plan must be filled out and signed by a parent and physician so we have a plan of action to be able to take care of the student. If the student has an inhaler, we need the inhaler information filled out on the action plan. Students are allowed to carry inhalers on them if the medication form states that the student is capable of self administration and signed by the physician.  Students are welcome to leave an inhaler locked up in the nurse’s clinic, with the trainer, and on the student if signed off by the physician.

Insect Sting Allergy Action Plan: If your student has a severe allergy to any type of insect sting, this form must be filled out and signed by a parent and physician so we have an action plan to be able to take care of the student. We must have an EpiPen in the nurse’s clinic if needed. The physician can specify on the form if the EpiPen needs to be carried on the student. Parents are encouraged to send a small bottle of Benadryl for student to use if needed as well. Must be in original container with a parent note accompanying bottle stating dosage and parent permission to administer if needed for allergic reaction.

Food Allergy Form: If your student has a food allergy, we need this form filled out and signed by a parent and physician. If the student requires an EpiPen, we need a medication form filled out for it as well. Please leave an EpiPen in the nurse’s clinic if needed. The physician can specify if the EpiPen needs to be carried on the student and self administered on the medication form. Parents are welcome to send a small bottle of Benadryl for student to use if needed as well. Must be in original container with a parent note accompanying bottle stating dosage and parent permission to administer if needed for allergic reaction.

Consent for Disclosure of Confidential Student Information: This form is for parents who want to sign off for confidential medical records to be released from a physician or medical facility to the LCM School Nurse in order to develop care plans and provide continuity of care.

Medicaid Parent Information: If your student has Medicaid, these flyers will answer questions about receiving free transportation to and from doctor appointments and will answer questions about how to apply for health benefits.