School Physical Information

FAITH REGIONAL PHYSICIAN SERVICE - WISNER FAMILY MEDICINE

From now through August 31, 2018, Faith Regional Physician Services- Wisner Family Medicine will be offering SPORTS PHYSICALS for $25.00 and SCHOOL PHYSICALS, K-7th GRADE for $75.00, either one paid at the time of service.  Students must provide school physical form.  Lab and immunizations are not included with the special prices.  Please check with your insurance company regarding well child or preventative medicine visit coverage and immunizations.  Contact Wisner Family Medicine at (402) 529-3218.

DINKLAGE MEDICAL CLINICS

From now through August 1, 2018, Dinklage Medical Clinics will be offering school physicals for $49 with a scheduled school physical appointment.  Parents must ask for the school physical rate.  The physical includes a free urine protein & urine glucose screening.  The clinics will accept insurance and co-pays. Immunizations and/or other additional services - medication refills, injury evaluations, acute problems (sore throat, swimmer's ear, rashes, etc.) - will be charged at the discretion of your physician.  

This special rate does not include college, kindergarten, Head Start, scouts, or any other types of physicals.

  1. Bring a completed "History Form".
  2. Bring a first morning urine sample, if not possible, any sample is fine.  To prevent unnecessary rechecks drink plenty of fluid 48 hours before sample is taken.  Samples can be collected at the appointment.
  3. The student must bring their immunization records.  This is an excellent time to get caught up on immunizations, especially for incoming 7th graders.  Common immunizations include Tetanus (includes pertussis for whooping cough), meningitis, and Gardisil.  NENCAP Immunization Clinics are available also; call at (800) 445-2505 for information.  Parents that won't be at the appointment requiring immunization need to contact the clinic and sign a permission form.
  4. Girls are reminded not to wear sports bras.  They impede the scoliosis check.
  5. Students need a second "Chicken Pox/Varicella" or a record of having Chicken Pox.

Please contact the clinic to clarify any information or to pick up any necessary forms.

At the end of each physical, the student will be given a "Consent to Participate" and "Physical"  form.  Because of HIPAA, the parent decides what information will be shared with the schools beyond the consent form.  We strongly encourage parents to share the entire physical form with the school in the interest of the health of your child, particularly if your child has health concerns that the school nurse and/or coaches should be aware of.

2018-2019 Sports Physical Form