TVES HEALTH CLINIC - FORMS

all MEDICAL FORMS MUST BE RENEWED EACH SCHOOL YEAR.

ALL PRESCRIPTION MEDICATIONS MUST INCLUDE A WRITTEN ORDER FROM THE DOCTOR TO BE ADMINISTERED AT SCHOOL. ALL MEDICATION MUST BE BROUGHT IN BY AN ADULT. DO NOT SEND MEDICATION IN WITH YOUR STUDENT, THIS INCLUDES COUGH DROPS. ALL FORMS MUST BE SIGNED BY THE PARENT/GUARDIAN AS WELL AS THE PHYSICIAN.

Medication Administration Form - Please download and complete this form.

Asthma Action Plan - Please download and fill out this form.

Epi Pen/Anaphylaxis - Please download and fill out this form.

Permission to Self-Carry - Please download and fill out this form.

If your child has special needs such as a gastrostomy tube, tracheostomy or requires special procedures such as urinary catheterization or tube feeding, these forms need to be downloaded and signed by the physican and parent/guardian - Special Procedure Request Medical Order for Specialized Health Care Procedures Tracheostomy Enteral Feeding Treatment Authorization Form

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