Medical Forms

    Health Care Plans


    Medication Forms
Medication Permission Form 
Self-Carry & Administration Form *Please note ONLY the following medications
can be self-carried: epinephrine auto-injectors,
asthma inhalers, & over-the-counter topicals

Medical Forms can be faxed to your student's building below.
Note, all medications must be brought in by a parent/guardian. 

    Fax Numbers
    Lake Shore High School (586)-285-8904
    North Lake High School (586)-285-8783
    Kennedy Middle School (586)-285-8804
    Masonic Elementary (586)-285-8504
    Rodgers Elementary (586)-285-8604
    Violet Elementary (586)-285-8704

Lake Shore Public Schools follows the Macomb County Health Department's Management Guidelines for
Communicable Diseases

Communicable Diseases
Communicable Disease Management

Katie Weidman
District School Nurse
(586) 285-8919
Send Email

Dr. George LewisApril Trontl
CNA at Rodgers Elementary

(586) 285-8655
Send Email

Dr. George LewisJennifer Wilson
RMA at Violet Elementary

(586) 285-8711
Send Email

Jennifer Bachman
RMA at Masonic Elementary
(586) 285-8519
Send Email