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Forms

Health Record Update

The Health Update form is a key communication tool for the school nurse in order to care for your child while at school. Even if there has been no change in health conditions, it is vital that this form be completed by the parent/guardian with each new school year.  For students in the 6th-12th grades, Tylenol permission authorization for the district stock Tylenol is also located on the health update form and must be completed each new school year for Tylenol permission.

Health Update Form For Returning Students  

Medication Authorization Forms

This form must be completed and signed by the parent/guardian before medication can be given while at school. This includes over the counter and prescription medications.  The medication administration policy is also found on this form.

Elementary Secondary

 

Allergy Forms Policy Handbook

This folder contains an emergency action plan that is required by the school district for those students who have been diagnosed with a severe allergy by their doctor. For those students who wish to carry their own emergency medications and self-administer when needed, there are also forms found here for this purpose.

Allergy Policy and Procedures Handbook Allergy Emergency Action Plan Allergy Self-Administration Packet

 

Asthma Forms

This folder contains an emergency action plan that is required by the school district for those students who have been diagnosed with asthma by their doctor. For those students who wish to carry their own inhaler and self-adminster when needed, there are also forms found here for this purpose.

Asthma Emergency Action Plan Asthma Self-Administration Packet

 

Diabetic Forms

This folder contains an emergency action plan that is required by the school district for those students who have been diagnosed with diabetes by their doctor. You will also find a medication self-administration packet within this folder.

Diabetic Action Plan Medication Self-Administration Packet for Chronic Conditions

 

Seizure Forms

This folder contains an emergency action plan that is required by the school district for those students who have been diagnosed with a seizure disorder by their doctor. The parent questionnaire for students with seizures can be found here as well.

Seizure Action Plan Seizure - Parent Questionnaire for Student with Seizures

 

Self-Administration Forms for Chronic Conditions

The forms within this packet pertain to chronic health conditions other than Asthma and Severe Allergies. The forms must be completed in order for your child to carry and self-administer their own medication(s) for chronic conditions such as diabetes, migraines, and others outside the nurse's office and completely independently of the school nurse while at school. Portions of this packet require a doctor's signature. The packets for self-administration for Asthma and Severe Allergies are found in the specific folders for these conditions.

Medication Self-Administration Packet for Chronic Conditions