Medication Forms
Your child may need a Health Plan
Your child may need a Health Plan
If your child:
If your child:
- Needs an asthma inhaler or nebulizer at school
- Has a food or environmental allergy and needs an EpiPen at school
- Will need medication given to them during the school day
- Has a chronic health condition
- Has any other health concerns
- Your child may need a Health Plan with the School Nurse
*If you have questions about your child's health needs, Contact the Nurse.
*If you have questions about your child's health needs, Contact the Nurse.
Prescription medications can be given to your child in the Health Office if...
Prescription medications can be given to your child in the Health Office if...
- Your child's healthcare provider fills out the Prescription Medication Authorization Form (located below)
- Prescription medication is given to the School Nurse in its original package from the pharmacy
- It must have your child's pharmacy label on it
Over the counter (OTC) medications can be given in the Health Office if
Over the counter (OTC) medications can be given in the Health Office if
- The Over-the-Counter Form (located below) is filled out by the parent/guardian and
- The medication is brought to the Health Office in a brand-new and sealed package
*Students are not permitted to carry any medications on their person unless the required paperwork has been given to the School Nurse.
*Students are not permitted to carry any medications on their person unless the required paperwork has been given to the School Nurse.
(RRPS policy #1029).
(RRPS policy #1029).
Most of these forms may be picked up in the LMS Health Office.
Most of these forms may be picked up in the LMS Health Office.
Click below for all forms
Asthma Action Plan
Asthma Action Plan (Spanish)
Allergy Action Plan
Medication Prescription
Medication Prescription (Spanish)
OTC Medication
OTC Medication (Spanish)
Diabetes Management
Diet Prescription
Seizure Medication
Authorization to Administer Specialized Health Services
Oxygen Administration
