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Medical/Health Plan Information

DeKeyser Elementary 2026 - 2027

Medical/HealthPlan InformationDeKeyser Elementary 2026 - 2027
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Dear DeKeyser Families,


Utica Community Schools are committed to providing a healthy and safe environment for each of our students. A health plan is required to be completed at the beginning of every school year for children with health conditions, severe allergies, and/or a child requiring medication during the school day. For your child's safety we ask that all health forms are turned in PRIOR to the first day of school on Monday, August 31st.


When is a Health Plan Needed?

Any condition that may involve special dietary considerations, activity accommodations, medications, or treatment of urgent problems. A signature from a licensed provider is required on all health plans.


Administration of Medication at School

Any medications that are to be distributed by school staff or used by your student at school must have an Authorization for Medication completed and signed by a licensed provider, including any over-the-counter medications, and be brought in by an adult. A separate Authorization for Medication form must be completed for each medication (only one medication per sheet).


Health Care Plans and Authorization for Medication forms are available at https://www.uticak12.org/domain/3272 Two transportation forms are required for every student that rides the bus with a COLOR picture attached to each form. Depending on your child’s diagnosis, the following forms are required by the school:


Please return all the necessary, completed and signed forms (dated after July 1, 2026) prior to August 31,2026 to: officedekeyser@uticak12.org

Food Allergies/Insect Allergies/Latex Allergies Food Allergies/Insect Allergies/Latex Allergies

  • FARE Food Allergy and Anaphylaxis Emergency Care Plan
  • UCS Special Diet Statement form
  • 2 Authorization for Medications (one for an antihistamine and one for Epinephrine)
  • 2 Transportation Forms (if your child is a bus rider)
pdf
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Food_Allergy_and_Anaphylaxis_Form.pdf
Download
2.7 MB
pdf
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UCS_Special_Diet_Statement.pdf
Download
404.0 KB
pdf
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Authorization for Medication 5325_FORM_1_Fillable.pdf
Download
227.1 KB
pdf
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Transportation_-_Health_Information_Card.pdf
Download
104.9 KB

UCS Special Diet Statement UCS Special Diet Statement

Required for Food Services for students with Food Allergies or other health conditions requiring specific meal accommodations.

pdf
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UCS_Special_Diet_Statement.pdf
Download
404.0 KB

Asthma Asthma

  • Asthma Health Care Plan
  • Authorization for Medication for a rescue inhaler
  • 2 Transportation Forms (if your child is a bus rider)
pdf
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UCS_Asthma_Health_Care_Plan.pdf
Download
991.8 KB
pdf
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Authorization for Medication 5325_FORM_1_Fillable.pdf
Download
227.1 KB
pdf
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Transportation_-_Health_Information_Card.pdf
Download
104.9 KB

Seizure Seizure

  • Seizure Health Care Plan
  • Authorization for Medication for rescue medications and/or other medications
  • 2 Transportation Forms (if your child is a bus rider)
pdf
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Seizure_Action_Plan_Epilepsy_Foundation_9-13-2023.pdf
Download
253.1 KB
pdf
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Authorization for Medication 5325_FORM_1_Fillable.pdf
Download
227.1 KB
pdf
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Transportation_-_Health_Information_Card.pdf
Download
104.9 KB

Diabetes Diabetes

  • Diabetes Health Care Plan
  • 2 Transportation Forms (if your child is a bus rider)
  • Must submit your Diabetes Medical Management Plan from your Endocrinologist
pdf
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UCS_Diabetes_Health_Care_Plan.pdf
Download
171.7 KB
pdf
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Transportation_-_Health_Information_Card.pdf
Download
104.9 KB

Heart Condition Heart Condition

  • Heart Condition Health Care Plan
  • 2 Transportation Forms (if your child is a bus rider)
pdf
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UCS_Heart_Condition_Health_Care_Plan.pdf
Download
271.0 KB
pdf
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Transportation_-_Health_Information_Card.pdf
Download
104.9 KB

Any Other Diagnosis Any Other Diagnosis

  • General Health Care Plan
  • Authorization for Medication (if needed)
  • 2 Transportation Forms (if your child is a bus rider)
pdf
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UCS_General_Health_Care_Plan.pdf
Download
107.4 KB
pdf
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Authorization for Medication 5325_FORM_1_Fillable.pdf
Download
227.1 KB
pdf
insert_drive_file
Transportation_-_Health_Information_Card.pdf
Download
104.9 KB

Health Care Plan No Longer Needed Health Care Plan No Longer Needed

Please have your licensed provider complete the below attachment and sign. The form should be returned to the school.

docx
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3A Health Care Plan End-Of-Year Letter for 26-27.docx
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27.2 KB

District Nurses District Nurses

Chrissy Groszkiewicz, RN

christine.groszkiewicz@uticak12.org

586-405-7493

Cluster 1

Beacon Tree, Beck, Crissman, Duncan, Messmore, Morgan, Roberts, Switzer Elementary

Malow Jr. High, Shelby Jr. High

Eisenhower High School


Megan Holmes, RN

megan.holmes@uticak12.org

586-980-0731

Cluster 2

Gibbings Preschool

Flickinger, Monfort, West Utica, and Wiley Elementary

Eppler Jr. High

Utica High School, IRC, Alternative Learning Center

Walsh Community Education (Day care/preschool and Adult Ed)


Alexandra Sorrentino, RN

alexandra.sorrentino@uticak12.org

586-703-0647

Cluster 3

Browning, Dresden, Ebeling, Graebner, Harvey, Havel Elementary

Bemis Jr. High

Henry Ford II High School


Emily Duzey, RN

emily.duzey@uticak12.org

586-980-0743

Cluster 4

Burr, Collins, Dekeyser, Oakbrook, Plumbrook (except for POHI/special education students), Schuchard, Schwarzkoff Elementary

Davis Jr. High, Jeannette Jr. High

Stevenson High School, UAIS, UCNECT


Tiffanie Polizzi, RN

tiffanie.polizzi@uticak12.org

586-719-2793


Plumbrook POHI and special education students

UCS Resources & Forms Webpage
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DeKeyser Elementary

Welcome to DeKeyser ~ Home of the DeKeyser Dolphins



Principal: Mrs. Shannon Hathcock

Administrative Assistant: Mrs. Lisa Russo

Clerk: Mrs. Heather Mansour


Office Hours: 8:30 a.m. - 4:30 p.m.

School Hours: 9:05 AM - 3:55PM (full days) and 9:05 AM -12:09 PM (half days)

Breakfast Hours: 8:45 - 9:05


Address:

39600 Atkinson

Sterling Heights, MI 48313


Office Phone Number: (586)797-4400

24 Hr Attendance Line (586)797-4499

Fax (586)797-4401


Email: officedekeyser@uticak12.org

Mrs. Shannon Hathcock
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