• School Nurse

    Kim Bittleston

      West Sylvan: 503-916-5690
    West Sylvan: 503-916-5690


     Forms and Documents

    You may download and print forms, however the parents signature on the form needs to be submitted to the school office (no emails or fax will be accepted).

    PPS Procedure Policies for Taking Medications at School

    Authorization for Medication Administration by School Personnel Form

    Self-Medication Agreement Form

    Self-Medication Agreement for Prescription Inhalers Form

    Vaccination Requirements


    Medical Links

    Multnomah County Health Department

    Mayo Clinic

     Multnomah Education Service District
    MESD Health Information


    Nonmedical Vaccine Exemptions

    Dear Parent or Guardian,

    Oregon law changed this year to remove old religious exemptions. We

    may need new information about immunizations for your child. If your child has a religious exemption to immunizations signed before March 1, 2014, you will need to take action to prevent exclusion from school this winter. Please turn in the information by December, or your child may be excluded from school this winter.

    If your child has received all the vaccines, fill in the dates on the Certificate of Immunization Status form and bring the certificate to the main office at school. Please remember to sign the certificate.

    If you would like a nonmedical exemption for your child, you need to turn in two forms:

    1. Certificate of Immunization Status—fill in the dates of any vaccines your child has received, and fill out the nonmedical exemption section by marking the vaccines for which you would like an exemption, and sign the form.


    2. Vaccine Education Certificate—get this certificate after receiving the required education about immunizations from a health care practitioner or after watching the online vaccine education module.

    For more information, go to www.healthoregon.org/vaccineexemption

    If your child needs a medical exemption, get a letter from the doctor with the information stated on the Certificate of Immunization Status form. Medical exemptions are reviewed and approved by the health department.