Action Plans for School Use

If your child requires an epi pen a new order and a non-expired epi pen are required for each school year. Please check the date on your epi-pen prior to bringing it to the school.

Food Allergy Action Plan.pdf

Food Allergy Action Plan

Epi pen allergy plan.pdf

Allergy Action Plan

If your child requires and inhaler at school, this form must be completed and the inhaler provided for the school. Students may carry their own inhalers if ok with physician and parent and is discussed with the nurse prior to student carrying them.

Asthma Action Plan_2016_08_26.pdf

Asthma Action Plan

Health Office Permission 18-19.docx

This form is REQUIRED for any student in the middle school. This form allows your child to receive any over the counter medications we stock and also provides contact information and consent. This is required to be filled out every school year.

If your child is receiving a prescription medications during school please have your child's physician fill this form out or fax an order. The medication will need to be brought in by the parent and controlled medications are counted upon drop off.

forms - prescription med.pdf

If your child requires an over the counter medication to be administered at school, please fill this form out and bring it with you when you drop off your child's medications.

forms - non prescription med.pdf
Medical Records Release.doc

This form is to be used for communication with physicians or other offices.