HEALTH FORMS (W/ INSTRUCTIONS)

HEALTH FORMS Quick Links

Health forms can be found on the FISD Health Services Website: http://www.friscoisd.org/departments/health-services/health-forms     

*Quick Links below (w/ instructions)

If your child has a medical diagnosis of a Life-Threatening Allergy, Asthma, or Seizures we prefer an Action plan & emergency medication to be kept in the clinic. A physician & the parent must fill this paperwork out so that we can better treat your child. This cannot be accepted without the signature from the physician. The Action Plans must be updated yearly.  Be sure to share your student’s care plan with pertinent staff such as teacher, coach, trainer, program director, bus driver, etc. 

All forms & medications must be turned in at the start of each new school year for the medical management for your child. These forms do not carry over from year to year, sorry! Please inform your child's teacher, coaches & school nurse of any pertinent information.

After all paperwork is properly filled out, it can be brought to the school or faxed directly to my office from the physician’s office. Medication may be dropped off in the nurse’s office. Students are not allowed to carry any medication in their backpacks, lunch boxes or pockets (including vitamins/supplements).

All Medications:

Medication:  Parent/Guardian Request Form  

• Use for ALL prescription, district approved over-the-counter medication & emergency meds listed on Action Plans.. This form must be completed every year and when changes are made. *Inhalers, Epipens: If the label is not attached, then you must have the physician fill out the paperwork and sign.  Each form holds two medications.

• Form requires parent signature for  acetaminophen (Tylenol), Ibuprofen (Advil/Motrin), Tums, Diphenhydramine  (Benadryl)

• Form requires a  doctor's signature for any other over-the-counter medications other than acetaminophen (Tylenol), Ibuprofen (Advil/Motrin), Tums, Diphenhydramine  (Benadryl) and/or after ten doses of the above-referenced medications have been administered in one school year.

Please Note:

• Parents must supply any medication

• Prescriptions must have a valid label

• All medications must be in the original container

• Expired items will not be accepted or administered, no exceptions

• Any medication that is not picked up by the end of the school year will be properly disposed of by Frisco ISD. 

• Expired medication will be properly disposed of by Frisco ISD. 

• Students are not allowed to carry any medication in their backpacks, lunch boxes, or pockets (including vitamins/supplements). 

Allergies:  Severe FOOD

Medication:  Parent/Guardian Request Form

• requires parent signature

• doctor's signature required:

  •  for over-the-counter medications other than acetaminophen (Tylenol), Ibuprofen (Advil/Motrin), Tums, Diphenhydramine  (Benadryl)

  • after ten doses of the above-referenced medications have been administered in one school year

• each form holds two medications

Emergency Care Plan

• requires parent's and physician's signatures

• can use physician's own form

Self-Administration of Prescription Asthma or Anaphylaxis Medication by Student

• requires parent's and physician's signatures

Special Diet and Allergy Accommodation

• requires parent's and physician's signatures

• email completed form to specialdiets@friscoisd.org

• NOTE: this form does NOT need to be renewed each year unless there have been changes

• A physician & the parent must complete this form so that the cafeteria knows that your child cannot have certain foods. The cafeteria does not have access to your child’s food allergy information – the only way they will know about it is if they have this form on file. Unless there is a change in a food allergy, the form only needs to be completed & submitted once while enrolled with FISD. The form can be found at: https://www.friscoisd.org/departments/child-nutrition/food-allergy-information  Please refer to the “Students with Food Allergy, Intolerance or Medical Disability” section.

Food Allergy Information and Consent

• requires parent's signature

Dietary Preference Request OTHER THAN FOOD ALLERGIES: https://www.friscoisd.org/departments/child-nutrition/food-allergy-information  Please refer to the “Meal Account and Dietary Preference” section.  This form is recommended to be completed so the cafeteria knows that your child cannot have certain foods. The cafeteria does not have access to your child’s dietary restriction information - the only way they will know about it is if they have this form on file.

Allergies:  Severe NON-food

Medication:  Parent/Guardian Request Form

• • requires parent signature

Emergency Care Plan

• • requires parent's and physician's signatures

  • can use physician's own form

Self-Administration of Prescription Asthma or Anaphylaxis Medication by Student

Asthma:

Medication:  Parent/Guardian Request Form

• requires parent signature

Emergency Care Plan

• • requires parent's and physician's signatures

  • can use physician's own form

Self-Administration of Prescription Asthma or Anaphylaxis Medication by Student

Seizures:

Seizure Action Plan

• • requires parent's and physician's signatures

  • can use physician's own form

Diabetes:

Medication:  Parent/Guardian Request Form

• requires parent signature

Diabetes Medical Management Plan

• requires parent's and physician's signatures

• or you can use physician's own form, but be sure to sign the parent line.

*Recommended Diabetes Supplies