The Atlantic and Pacific coasts are the boundaries of Lyme disease with the Northeastern and Midwestern regions of the United States continuing to report the majority of cases. New reported cases of Lyme disease doubled from 1991 to 2001 according to statistics published by the Centers for Disease Control and Prevention (CDC, 2002). Within that population are more children between the ages of 5 and 9. The younger the child, the more difficult it is to diagnose Lyme disease. Children under the age of 19 are at high risk for Lyme disease because of the amount of time spent in outdoor activities during the late spring and summer. These months correlate with the tick breeding cycle and the peak time for outdoor recreational activities. Lyme disease can pose serious health risks in late stage illness. A Lyme disease case study on a school-age child provides comprehensive assessment data, interventions, and educational information for parents. A template of an individualized healthcare plan using standardized language is a guide for school nurses. The value of school nurses as guardians of the public's health is addressed. (Contains 8 tables.)