Date: _______________________
School: _______________________
Re: Transportation Requests
Dear Doctor/Healthcare Provider,
This letter is in regard to requests for transportation for medical issues. Extensive information
is needed to make correct determinations concerning transportation for health issues. These
are some general guidelines as to the information needed to base these requests on:
Full diagnosis needed;
Medications need to be listed with amounts, times, etc.;
Copy of a physical done within the past year;
Limitations in any activities, i.e., how far can a child walk (corner stop for bus pick
up), can participate in sports and/or school activities, etc. specifically, which ones?;
What specifically aggravates child condition, if any, i.e., walking (distance?) or
climate changes, chemicals, etc?;
Duration of problem; does child need transportation for full year or only for fall and
winter months (11/1 4/1);
Past medical history to support need for transportation accommodations such as
treatments, hospitalizations, extenuating circumstances, etc.;
Whether child can use public transportation (if an older child);
A form letter is not acceptable documentation for transportation at this time, as detailed
information is needed to make an accurate determination of the child’s need. A diagnosis of
asthma does not automatically ensure transportation accommodations, but supporting
evidence will help us make a better decision for the child. Please remember, transportation for
medical issues is reserved only for children with the most critical of needs and the Cleveland
Municipal School District does retain the right to refuse transportation except for those
deemed most necessary.
If you have any questions, please feel free to call me in my clinic at (____) _____ - ______ or
at pager (____) _____ - ______.
Again, thank you for your time and cooperation.
School Nurse