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Health Forms

All forms must be renewed every school year. Please make sure that all forms are signed by the physician and yourself prior to bringing them into school.
Asthma & Inhaler Use
  • Your child’s physician must complete and sign the Asthma Treatment Plan.
  • Parents/Guardian must sign the bottom of the Asthma Treatment Plan.
  • Inhalers must be in the prescription labeled box and hand delivered to the school nurse by the parent or guardian.
EpiPen Use
  • Your child’s physician must complete and sign the Anaphylaxis Emergency Care Plan.
  • The Parent/Guardian must sign the bottom of the Anaphylaxis Emergency Care Plan (remember to indicate on the bottom of the form if you wish for your child to sit at a peanut/nut free table at lunch).
  • EpiPens must be in the prescription labeled box and hand delivered to the school nurse by the parent/guardian.
Medication Administration
  • Your child’s physician must complete and sign the Medication Authorization Form.
  • The parent/guardian must sign the bottom of the Medication Authorization Form.
  • All medications (prescription or non-prescription) must be in its original container and properly identified and hand delivered to the school nurse by the parent/guardian.