The following forms are available for you to print and complete. In addition to parent input, some of the individual health care plans require completion by, and a signature from, a physician.
Contact your School Nurse if you have questions or concerns. Return the completed care plans to your school nurse as soon as possible.
The parent is responsible for informing the school of medical care that is needed and for completing the care plans.
Licensed health care providers' orders are required for specialized health services such as Epi-pen injection, self administration of medications during school, blood glucose monitoring (insulin administration), gastrostomy tube feedings, clean intermittent catheterizations, nebulizer treatments, food allergies, etc.
- Allergic Reaction parent-physician info
- Asthma parent-physician info
- Administration of Medication at School, Authorization
- Administration of Medication- Self Carry
- Administration of Herbal Supplements at School, Authorization
- Consent to Release Medical Information
- Diabetes Medical Management Plan
- Diabetes Medical Management Plan, Insulin Pump
- Diabetes Supply List Needed for School
- Nutrition Services Physician Letter
- Personal Health History
- Immunization History
- School Dental Examination
- Seizure parent-physician info
- Sports Physical - Pre-participation Physical Evaluation
- School Entry Physical Exam
- Concussion Fact Sheet for Athletes
- Concussion Fact Sheet for Parents
- Concussion and SCA Acknowledgement Form
- Concussion Health Care Provider Return to Play Form
- Sudden Cardiac Arrest (SCA) Fact Sheet for Student Athletes
- Sudden Cardiac Arrest (SCA) Fact Sheet for Parents
Forms Available in Spanish
- Aviso de vacunación para todos los estudiantes que vayan a matricularse en la escuela
- Examen dental de la escuela
- Expediente físico y de salud del estudiante
- Historial de Salud
- Registro de vacunación
- Suministro de medicación en la escuela (Guía para los padres)