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Health Office Forms

  • ALLERGY Action Plan

    This is used for children with allergies to foods, medications, insects etc that require prompt action and potentially the use of an automated epinephrine injector. 

  • ASTHMA Action Plan

    This form MUST be completed for any student with asthma that requires the use of an inhaler and/or nebulizer.  Students are not permitted to carry inhalers without this paper work. 

  • Diabetes Management Plan

    Complete this form if your child is diabetic.

  • Medication Needed During School Hours Form

    This form is REQUIRED to be filled out by the child's physician if medication needs to be given during school hours.  This must also be signed by the parent/guardian.  Medications can not be given without this form.

  • Permission for School MD to Complete Student Physical

    This form MUST be completed if your child requires a physical and you would like the School MD to perform the physical. 

  • Personal Doctor Physical Form

    This can be used by any student needing a physical that is NOT RELATED to SPORTS.

  • Seizure Action Plan

    Complete this form if your child has seizures. This will assist in quick response customized for your child's needs.