Forms & Action Plans

Required upon entry, 6th & 11th Grade

Required upon entry, 3rd & 7th Grade

Any medication at school must be ordered by a physician along with parent signature.

Please have your students physician complete this if they have any allergies that may require medical intervention or medications if encountered (i.e. benadryl, epi-pens).  The school does have epi-pens on hand for emergencies but it is best to send in their own just in case our stock is depleted or used.    

Please complete this form along with the “medication at school form” if your child has asthma and/or has an inhaler that will be available for school use.  

Inhalers and Epinephrine (Epi-pens) are the only medications that are allowed to be kept in the classroom for use as needed.  Please review this policy (Policy #210.1) and complete the form if your child is capable of administering their own inhaler/epinephrine.  The nurse will evaluate and determine if self-administration is appropriate during school hours. 

Please have your student's physician complete this plan for any and all types of seizures.  For use even if your student does not have any breakthrough seizure meds. 

This will need completed if your student has any dietary concerns or needs that require modification to the daily menu.