Health Care Plans and Forms

Asthma

Please submit School Asthma Emergency Plan and the state required Asthma Self Authorization Form annually.

• School Asthma Emergency Plan
• Asthma Self-Administration Form
• Formulario para la Auto-Administración de Medicamentos contra el Asma (en Español)

Concussion Care Plan

• Concussion Care Plan

Diabetes

Please submit the Diabetes School Health Care Plan and state required Glucagon Authorization if requesting to have Glucagon at school annually.

• Diabetes School Health Care Plan
• Glucagon Authorization Form

Food Allergy

If your student requires an Epi Pen you must submit an Epi Pen Authorization form. If your student requires an inhaler you must submit the Asthma Self Authorization form. All medications given for an allergic reaction must be written on the Food Allergy Action Plan. All forms must be signed by your doctor and submitted annually.

• District Allergy Policy
• Food Allergy
• Epinephrine Administration Form
• Asthma Self-Administration Form

Medication Policy and Medication Form

• Administering of Medication to Students by School Personnel
• Medication Form
• Suministro de Medicina a los Estudiantes Realizado por el Personal Escolar (en Español)
• Formulario de Autorización Médica (en Español)

Other Health Services Forms

• School Immunization Requirements for the 2012-2013 School Year
• Requisitos de Vacunas para el Año Escolar 2012-2013 (en Español)
• Information for parents from the High School Nurse
• Informacion para los padres de enfermera de la escuela secudaria (en Español)

Seizure Care Plan

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

• Seizure School Health Care Plan