These forms are for asthma management. Includes asthma emergency treatment plan and medication prescription forms.
These forms are for allergic reaction management. Includes emergency treatment plan and medication prescription forms.
Diabetes Management plan
For the student with diabetes. All forms must be completed appropriately and medications provided to the school nurse no later than the 1st day of the school year.
Seizure Management Plan
This for students with seizures, form should be completed appropriately and submitted to the Nurse with any prescribed medication no later than the 1st day of the school year.
Health Physical Form
Needed by the health office for health history updates. Completed by parent and student`s Physician or Advanced Practice Nurse (APN). Please attach immunization records.
OTC and Prescription Medication Form
This form is for prescription and Over the Counter (OTC) medications. Must be completed by parent and physician before medication can be administered at school by the school nurse.
Authorization for Administration of OTC Medication for Acute Illness at School
The school physician has authorized the administration of Tums, Ibuprofen, and Tylenol if needed with parent`s/guardian`s permission.