School Nurse

Anne Alexander RN BSN NCSN 

Anne Alexander RN BSN NCSN

PCSD School Nurse

Jeremy Ranch Elementary School

(435) 645-5670 ext. 1753


Parents and/or Guardians,

I appreciate the opportunity to work with your students at Jeremy Ranch Elementary School and be a School Nurse for the Park City School District. Our shared district nursing goal for your children is to keep them healthy and provide preventive health measures throughout the school year. Please contact me if you have any questions or concerns regarding your student or the Park City School District Health Service department.


Utah Immunization Rule for Students R396-100

All children who attend school are required by the Utah Immunization Rule for Students to provide proof of immunization, an exemption, or proof of immunity against a disease for which vaccination is required.  Proof of immunity to disease(s) can be accepted in place of vaccination only if a document from a healthcare provider stating the student previously contracted the disease is presented to the school.  Conditional enrollment and exclusion criteria apply as outlined in the Utah Immunization Guidebook.  Students must be on track for completing missing immunizations as the school year progresses. Exemptions are allowed and must be obtained at the Summit County Health Department, or thru an online module at


The following immunizations are required:


  • DTP:  3-4 vaccines (depending on age)
  • Polio:  3-4 vaccines (depending on age)
  • MMR:  1 vaccine (must be given after the 1st birthday)
  • HIB:  3-4 vaccines (depending on age)
  • Hepatitis B:  3 vaccines
  • Hepatitis A:  2 vaccines
  • Varicella:  1 vaccine
  • Pneumococcal:  3-4 vaccines (depending on age)

Kindergarten and Grades 1-5:

  • 5 DTP (4 doses if 4th dose was given on/after the 4th birthday)
  • 4 Polio (3 doses if 3rd dose was given on/after the 4th birthday)
  • 2 MMR (first does must be given on/after the 1st birthday)
  • 2 Hepatitis A
  • 3 Hepatitis B
  • 2 Varicella (history of chickenpox is acceptable, but only if the parent provides the school with a document signed by a healthcare provider as proof of immunity

**Please note In the event of an outbreak students who have claimed an exemption or are on conditional enrollment and have not received the immunization for which there is an outbreak must be excluded from school.


VISION SCREENING is done in grades Pre K, K,1,3,5

Please see this link to the District School Nurse Website for information on Vision Screening:    Vision Screening Information

School Vision screening is done in the Fall. A notification will be sent to parents by email or e-blast announcement. Parents have the option to opt their student out of the screening process. Please submit an Opt-out form found at the above link.

Please note **If a student does not pass the vision screening after two attempts, a referral letter is sent by the nurse to parents recommending follow up with an eye doctor. If your student is absent or did not have his/her glasses/contacts on screening day, please contact Anne Alexander RN to set an appointment for a vision screening.


Scoliosis Screenings.

Scoliosis is an abnormal curvature of the spine. Scoliosis screening information for parents to screen at home is available on the PCSD website under the Health Services Department. 


Other Information and Forms


HEALTH RESOURCES: District Health Services Webpage 



If your student requires medication at school, whether it be a daily medication or as needed for ie Tylenol or Ibuprofen, a PCSD medication permission form must be completed by the parent and signed by a physician, Medication Permission Form


An Epipen Authorization and/ or Allergy Emergency Health Plan form must be submitted to the school if a student is to carry or store an Epi-pen at school. This form must be signed by a parent and Health Care Provider annually. Parents designate on the form if a student is to carry the epi-pen or if an epi-pen is to be stored with the Nurse in the health room. 

Allergy Emergency Health Plan   

 Epi Pen Authorization Form


An Asthma Self Authorization form must be submitted to the school if your student is to carry and self-administer his/her inhaler. This form must be signed by a parent and health care provider annually.

 Asthma Medication Authorization Form   

 Asthma Action Plan


Health Care Plans are needed if your child has a medical concern and may require medical intervention at school. Contact School the School Nurse If your student may require a health plan. It is parent responsibility to contact the school nurse each school year to renew and to keep a health plan current. It is the parent/guardian’s responsibility to inform all student’s teachers of medical concerns. Health Plans 


Any special diet requests need to be submitted to the Nutrition Services Department. Special Dietary Request Form 


Please ensure you complete the Registration Process by updating your student’s Emergency Contact Information each school year.


Parents of students with health concerns may contact the transportation department at 645-5660 to discuss concerns.