This page contains health forms for your convenience.  Please assure that they are filled out, signed and dated by your physician.  If you would like to have medications stored at school, you must bring and sign them in with me in the clinic.  No child is permitted to handle medications.  Feel free to contact me with any queries.

Authorization for Students to Carry a Prescription Inhaler, Epinephrine Auto Injector, Insulin, and Diabetic Supplies, or Other Approved Medication-English

Authorization for Students to Carry a Prescription Inhaler, Epinephrine Auto Injector, Insulin, and Diabetic Supplies, or other Approved Medication-Spanish

Diabetes Action Plan

Food / Insect Allergy Action Plan - English

Food / Insect Allergy Action Plan - Spanish

Individualized Health Care Plan

Information for School Management of Diabetes Mellitus

Parent Request and Authorization for Specialized Healthcare

Parent Request for Physician's Orders

Questionnaire for Parent of a Student with Seizures

Request for Administration of Medication - English

Request for Administration of Medication Form - Spanish

School Asthma Action Plan

Seizure Action Plan

Vision and Hearing Screening Request Form - English

Vision and Hearing Screening Request Form - Spanish