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Medication and Health Service Forms

Medication 

Medication should be limited to those required during school hours and necessary to maintain your child’s enrollment and attendance in school. If your child requires medication at school, please review the Parent Letter for guidelines for medication administration, and complete the appropriate medication form.

Parent Letter (ENG & ESP)

 

Permission for Medication Administration

 

Permission for Medication Administration - Non-prescription and Prescription (ENG) 

Permission for Medication Administration - Non-prescription and Prescription (ESP)

 

Chronic Health Condition Order Forms 

All forms must be completed by parent and physician.

Adrenal Crisis Action Plan

Anaphylaxis Action Plan

Asthma Action Plan

Cardiac Action Plan

Hemophilia Action Plan

Seizure Emergency Action Plan

GTube Feeding Physician Orders

 

 

 

 

Head Injury Forms 

A Fact Sheet for Parents (ENG)

A Fact Sheet for Parents (ESP)

 

For School Use Only

Concussion Signs and Symptoms Checklist (ENG)

Concussion Signs and Symptoms Checklist (ESP)

Student Accident and Injury Report Form (ENG)

 

Last Updated: June 14, 2024