Forms

Will your child need medication at school?

You will need to complete the MEDICATION ADMINISTRATION FORM.  This form will need to be signed by a doctor if medication is required for more than 10 doses or 10 days.


Does your child need to carry an inhaler?
The following form needs to be completed by you and your healthcare provider:

Asthma Self-Administration Form

Does your child have a severe allergy requiring a physician prescribed epinephrine auto-injector?
The following form needs to be completed by you and your healthcare provider:

EPINEPHRINE HEALTH CARE PLAN

Severe Allergy Disclosure Form - English

Severe Allergy Disclosure Form - Spanish

Does your child have diabetes?
Please contact your campus nurse to set up a meeting via phone or Zoom to discuss your student's needs for the coming school year.

Does your child have seizures?
Please contact your campus nurse to set up a meeting via phone or Zoom to discuss your student's needs for the coming school year.

Does your child require special medical procedures such as tube feedings, catheterization or other procedure while at school?

Please consult your campus nurse. The following form needs to be completed by you and your child's healthcare provider:

Specialized Medical Procedures Form

Is there any other health information you would like to share with the school nurse?
Please complete the following form and return it to your campus nurse:

     Emergency Information for School Health Clinic


If you have any questions about the forms above or if your child has a health condition that will require special consideration at school, please contact the campus nurse at your child's school.