Student Health Forms
For students with specific medical needs, forms below are provided for your convenience. New forms must be completed and submitted to your school nurse each academic year.
Allergies
Family Food Allergy Health History Form
Food Allergy Action Plan (action plan required for students with epinephrine orders)
Allergy Action Plan Non-Food (action plan required for students with epinephrine orders)
Request for Food Allergy Information - English
Request for Food Allergy Information - Spanish
Request for Dietary Accommodations
Dietary Accommodations Discontinuation Form
Asthma
Asthma Parent Questionnaire - English/Spanish
Diabetes
Guidelines for Student Independent Diabetes Monitoring and Treatment at School
Physician’s Authorization for Student Independent Diabetes Monitoring and Treatment at School
Diabetes Medical Management Plan
Diabetes Transportation Emergency Plan
Health Information Update
Health Information Update Form
Medication
Permit to Carry and Self-Administer Asthma and Anaphylaxis Emergency Medication (secondary students)
**UPDATED** Parent-Physician Permission to Administer Medication Form
Seizure Disorder