School Health Forms

Medication Forms

For questions and assistance with medication forms, please contact your child's school or the Hawaii Keiki Health Hotline at 844-436-3888 , available Monday through Friday, excluding HIDOE holidays and breaks. 

For medications related to anaphylaxis, asthma, seizures, and other daily medications:

• • SH36 - Request to Store and Administer Medications (rev. 2/2024)

For medication and care related to diabetes:

• • SH36 DM - Request for Diabetes Care and Medication Administration (rev. 1/2024)

For students to self-administer albuterol inhaler, epinephrine auto-injector, and/or glucagon:

• • Student Medication Self-Administration and Carry Authorization (rev. 1/2024)

To allow volunteer DOE employees to administer epinephrine auto-injector and/or glucagon:

• • Volunteer Authorization to Administer Epinephrine and Glucagon (rev. 6/2023)