Forms
Complete the Medication Administration Form for all prescription medication, including district approved over-the-counter medication – Acetaminophen (Tylenol), Ibuprofen (Motrin), Diphenhydramine (Benadryl), Tums: Required medication including district approved over-the-counter medication must be supplied by the parent. All prescription medication must have the original prescription label attached. District approved over-the-counter medication may be administered up to 10 doses. After 10 doses, a physician’s note/prescription will be needed to continue to administer the medication.
Severe Allergy Action Plan – Asthma Action Card – Seizure Action Plan: A physician and the parent must fill this paperwork out so that I can better treat your child. This cannot be accepted without the signature from the physician.
Food Allergy Substitution Form: A physician and the parent must complete this form so that the cafeteria knows that your child cannot have certain foods. This form only needs to be completed & submitted to cafeteria once unless there is a change in the food allergy.
Food Allergy Information & Consent Form: Must be completed by a parent so that I can communicate with teachers regarding the food allergy. (Note: if your child has a peanut allergy, this must be completed to have your child sit at the “Peanut Free” table).
Medication: I prefer to keep medication (Benadryl, Epi-Pen, or inhalers) here for the year in case of emergency. Please make sure that the Medication Administration form is complete and have the prescription labels attached to the medication. If you want your child to carry his/her own inhaler/Epi-Pen, please turn in the " Self Administration of Prescription Medicine by Students" that requires doctor's signature.