Mt. Diablo viewed from Mt. Wanda, © 2020 Kevin Smith, used with permission.
If your child needs to take medication during school hours, fill this form out with your healthcare provider and deliver it to the school. Medications must be picked up at the end of each school year. This form must be renewed annually.
Medication must come to the front office with form completed and signed by parent/guardian and healthcare provider, and:
be properly labeled in a bag with student's name and grade
in original container with expiration date
prescription medications must have name/telephone of pharmacy, student's name, and name and phone number of healthcare provider
💊Seizures / Epilepsy emergency medication forms
Parent request for emergency anti-seizure medication in the school
If your child needs to have emergency anti-seizure medication available at school, have both of these forms filled out and deliver them to the school. You will also need to turn in a completed Seizure Action Plan. Medications must be picked up at the end of each school year. These forms must be renewed annually.
Medication must come to the front office with form completed and signed by parent/guardian and healthcare provider, and:
be properly labeled in a bag with student's name and grade
in original container with expiration date
prescription medications must have name/telephone of pharmacy, student's name, and name and phone number of healthcare provider
During the kindergarten year or upon first enrollment or entry in a California school district of a pupil at an elementary school, and in grades 2, 5, and 8, the pupil’s vision shall be appraised by the school nurse or other authorized person under California Education Code (CEC) §49452. Vision appraisal may be waived by presenting a certificate from a physician and surgeon, a physician assistant, or an optometrist setting out the results of a determination of the student’s vision, including visual acuity and color vision.
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