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Welcome to the Stackhouse Nurse's Webpage!
Please click on any of the underlined words to view/print the form that is mentioned.
At least once a year, your child is called to the health office for vision, hearing, scoliosis, B/P and height and weight screening. Then there are other visits for illness, injuries and playground accidents, personal problems, “Monday morningitis”, daily medications and many other reasons. The office is very busy and at times seems like a “mini emergency room”. Taking care of ill and injured students and giving daily medications is my main priority during the day. If I do not answer the phone, please leave me a message and I will get back to you as soon as possible.
Often, your help as parents/guardians is needed in caring for your child. Please complete/review the forms below every school year and send them in to the nurse:
Emergency Information Verification Form - It is important to make sure the phone numbers are correct and you provide emergency contact phone numbers. Please notify us of any changes. If you would like your child to be able to take generic Tylenol/ibuprofen at school, make sure to check “yes”, sign and date the form. We are not allowed to take permission from you over the phone, it must be in writing for legal reasons.
Request for Medication Administration Form - Any medication (prescription or over-the-counter) that your child may need while at school, must be in the original pharmacy vial/package and accompanied by this form and/or a doctor’s note.
District Medication Policy. For everyone’s protection, it is best if the parent/guardian brings the medication and paperwork directly to the nurse's office.
Due to limited resources and very limited space, it’s important for you to keep your sick child at home. We’ll work with you by keeping your healthy child in school and calling you only when we feel it is necessary. Please review the Student Handbook - Health section (located on the district's webpage, under parents), it should be able to answer any questions you may have concerning medical issues at school.
Asthma Action Plan Instructions
Asthma Action Plan - Fill out if your child has asthma and needs medication at school. Your doctor will need to fill out the entire form, sign, date and stamp it with his/her office's information. You, the parent/guardian, will need to sign the bottom of the form as well.
Anaphylaxis Care Plan – If your child has any type of allergy (food, latex, bee, etc.) you will need to complete. Your doctor will need to fill out the entire form, sign, date and stamp it with his/her office’s information. You, the parent/guardian, will need to sign parts of the forms as well.
Food Allergy Questionnaire Form - If your child has any type of food allergy, you will need to complete this form. This is very important as the information is shared with all appropriate staff (teachers, cafeteria, etc.) about your child's food allergies.
Diabetes Forms - Please contact the nurse concerning any diabetic forms. Most doctors’ offices will only use their forms concerning diabetic students. We will accept your doctor’s forms as long as no important information is missing per state law. If any needed information is missing, we will give you that section for your doctor to complete.
Seizure Forms- Please fill out both of the forms below if your child has a seizure disorder. One is a parent questionnaire and the other is a care plan that needs to be filled out by your child's doctor. Your doctor will need to fill out the entire form, order medication if needed, sign, date and stamp it with his/her office's information.
It is important for you to let us know if your child will be staying before/after school, so the appropriate staff members can be trained. Students must follow those programs' protocols concerning medication administration.
Universal Child Health Record - NJ state law requires children from Kindergarten through 5th grade to have at least one school entry physical exam on file. You will need parts of the form to be filled out by your family physician and it must be signed and stamped by the physician's office.
Pemberton Township Local Health Resources - A great resource for all of your health care needs.
Screenings - Screenings will be completed by the school nurse according to NJ state requirements. If you do not want your child to be screened, please notify the school nurse in writing at the beginning of the school year. A notice will be sent home of any deviations from the recommended standards and you will be asked to follow up with your child's physician.
Please call or e-mail me if you have any questions or concerns about any of the above information.
Heather Verner-Hussmann, BA, RN, CSN "Nurse Heather"
hverner@pemb.org Phone 609-893-8141, Ext. 1133 Fax 609-757-4773
Stackhouse Elementary School Nurse - 125A Trenton Road, Browns Mills, NJ 08015
Grades K - 2
*All forms may be scanned, faxed, or emailed to the School Nurse:
How to Scan a Document from Your IPhone/IPad
How to Scan a Document from Your Android Device
Google Voice # 609-283-2280,
You can take a picture with your phone and text to the above google number
Additional helpful information:
