Park City School District

Health Care Plans

Allergy Health Care Plan

Please submit "Allergy & Anaphylaxis - Emergency Action Plan." If your student requires lunchroom accommodations submit the "Medical Statement to Request Special Meals, Accommodations, and Milk Substitutions." If your student rides the bus submit the "Allergy Bus Form." If your student has asthma submit the "Asthma Action Plan." These forms must be completed annually with parent and healthcare provider signature.


Please submit the state required Asthma Action Plan Medical Authorization & Self-Administration Form annually..

Concussion Care Plan



G-Tube Feeding Order


Lunchroom Accommodations

Medication Administration

Medication Forms for School Nurses

Seizure Care Plan

Please submit Seizure School Health Care Plan signed by your doctor annually.

Transportation Forms