Embedded Files
Asthma & Allergy Documentation
Asthma & Allergy Documentation
For students that have a health diagnosis (allergies, asthma, diabetes, seizures, etc.), you will need to contact the school nurse to set up needs for medications, provider orders and action plans as soon as possible. Even if your student will not have any mediations or supplies at the school, an action plan is required in case of an emergency.
Asthma Forms
Asthma Forms
All three forms are required for inhaler use or carry at the school. All forms require a health care provider signature.
Asthma Action Plan_Medication Consent Form.pdfAsthma Action Plan
Prescription Medication Consent Form 2023.pdfAuthorization for Prescriptions
3416F Montana Authorization to Carry and Self-Administer Medication.pdfSelf-Administration Form
Allergy Forms
Allergy Forms
Please obtain a health care provider signature before submitting to the school nurse.
AAP_Allergy_and_Anaphylaxis_Emergency_Plan.pdfAllergy & Anaphylaxis Emergency Care Plan
FARE Form.pdfFood Allergy & Anaphylaxis Emergency Care Plan
Page updated
Report abuse