School Nurse
Kimi Blaschak, BSN, RN, LSN
Phone: 937-848-2131
Hello, my name is Kimi Blaschak. I have been the Bellbrook Middle School nurse since January of 2018. As your school nurse, my job is to keep your children healthy, safe, in school and ready to learn. I will also provide health assessments, vision and hearing screenings, monitoring communicable diseases and immunization compliance, providing for emergency intervention for illness, injuries, and other urgent situations, maintaining health information to accommodate the needs of students, and recommending, implementing and supervising school health policy and protocols including medication administration and staff wellness.
Before I started working at Bellbrook I was the school nurse at St. Luke Catholic School in Beavercreek, Ohio for 9 1/2 years. Prior to being a licensed school nurse, I worked for 9 years as a nurse in the Intensive Care Unit at Southview Hospital, 1 year in the Recovery Room at Southview Hospital, 3 years in a Neurology Office for five Neurologists and 5 years in the Emergency Rooms at Southview/Grandview Hospitals. I received my Associates Degree (RN) in nursing from Sinclair Community College in 1990, my Bachelor's Degree of Science in Nursing (BSN) from Miami University in 1993 and my School Nurse Licensure (LSN) from Wright State University in 2015.
I live just outside of Bellbrook with my two children, Alex and Brittney, and three dogs, Mulligan, Marshmello and Murphy
7th Grade Immunizations
Dear Parents and Guardians,
In order to protect your child from Pertussis or Whooping Cough as well as Meningitis, Diphtheria and Tetanus, all students who will be seventh graders are required to have two additional vaccines, the Tdap booster and one dose of the Meningococcal vaccine prior to the start of the new school year. If your child has not received these vaccinations yet, please schedule the appointment now to avoid the last minute rush late in the summer.
In addition, you have several options in providing the school this documentation. Unless your child was a new student in the sixth grade, we most likely do NOT have documentation that your child has received the vaccines. It is important that all parents provide the dates for when your child received the vaccines.
- You can either print the above attached letter and record the dates and provider of the vaccines. Mail, email, scan or send it to school with your student to the attention of the school nurse.
- OR you can mail, email, scan or send into school a copy of your child's most recent immunization record that includes the dates for the Tdap and MCV4 vaccines.
Please contact the school nurse, Kimi Blaschak at 848-2141, ext. 3108
Medical Forms
-
Authorization to Administer Prescription and/or Over-the-Counter Medication
This form is for ALL prescription medications as well as Over-the-Counter medications that either exceed the recommended dosage on the label and/or need to be given more than THREE times during the school year.
-
Authorization for Student Possession and/or Use of an Epinephrine Autoinjector, Asthma Inhaler, Gluc
Authorization of Epi-pen, Inhaler, and/or Glucagon. In addition, this form can also be used for those students who have Type I Diabetes and need access to their glucose meter at all times. To be completed by parent / guardian AND physician.
This document helps to determine the student's readiness to carry their inhaler based on their knowledge and understanding of Asthma symptoms and how to respond.
This form is available to families who have students with asthma. Please email the completed form to your school nurse.
Epi-pen and Inhaler Self-Carry Agreement
We are also adding the self-carry agreement form which must be completed by student, parent and school nurse when a student carries those emergency medications.
-
This form is to be completed by all parents who request an immunization exemption for their child based on medical, religious or philosophical objections. Please remember that in the event of an outbreak of a particular illness that is covered by a vaccine (an outbreak may be defined as only one case), your child will be excluded from school until the outbreak has been cleared by the health department unless you decide to have your child immunized at that point.
-
This form is available to families who have students with food allergies. Please email the completed form to your school nurse.
Detailed description of information for parents, staff and students in order to safeguard our children at school who have significant food allergies.
-
Please complete all questions. This information is essential for the school nurse and school staff in determining your student's needs and providing a positive and supportive learning environment.
In the event that your child has a seizure at school, please complete the following care plan so that we can provide the best possible care.