Health Forms

MEDICATION  AT SCHOOL: All medications, including nonprescription medications, brought to school by a student must be kept in the campus clinic in locked storage.  Students shall not be allowed to carry medication with them during the school day.

An exception may be granted by the campus administration if the medication is accompanied by a physician’s statement indicating that it is necessary for the health of the student that the medication be kept by the student.

The Medication Authorization Form should be completed and sent with each medication. (form below)

STUDENTS WITH ASTHMA: Student’s that will self-carry an inhaler or will be receiving medication at school for their asthma should have an Asthma Action Plan in place and signed by physician and parent/guardian. (Asthma Information forms found below)

DIABETES FORMS AND INFORMATION: Parent/guardian submits to the school a Diabetes Management and Treatment Plan developed by the parent/guardian and physician or submit the school’s Diabetes Medical Management Plan.  This must include parent and physician signatures.

  • The school nurse will use the student’s Diabetes Management and Treatment Plan to develop an Emergency/Individualized Health Plan.

  • Diabetic Student Contract should be filled out if appropriate for student age. (contract found below)

Students who may experience allergic reactions to foods, insect stings, or other allergens should have an Anaphylaxis Emergency Care Plan . This plan should be signed by parent and physician.
Other Anaphylaxis Forms