School Health Forms

• Medications. Please return Physician Order, Parent Permission and labeled medication with one-week’s supply to the health office.
  • Medication Policy Letter
  • School Medication Request Form
• Specialized Physical Health Care Procedures. One set of forms for each service requested.
  • Request for Specialized Health Care Services (H-78)
  • Physician Authorization for Specialized Procedure (H-77)
  • Physician Report (H-49)
• Diabetic Care Paperwork.
  •  Parent Consent for Diabetes Medical Management Plan
• Emergency Plans.
  • Allergy Action Plan
  • Asthma Action Plan
  • Food Allergy and Anaphylaxis (FARE) Packet
  • Meal Accommodations
  • Seizure Action Plan
• Modified PE Request
• Oral Health Assessment (H-51)