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REQUIRED FORMS AND SUPPLIES FOR SPECIFIC HEALTH CONDITIONS
REQUIRED FORMS AND SUPPLIES FOR SPECIFIC HEALTH CONDITIONS
ASTHMA
Required Forms
Required Supplies
Rescue Medication, Spacer for Inhaler or Nebulizer tubing/mouth piece/mask set up if prescribed
ANAPHYLAXIS
Required Forms
Required Supplies
Epinephrine Autoinjector, Benadryl if prescribed as part of care plan
SEIZURE DISORDERS
Required Forms
Required Supplies
Emergency Seizure Medication
TYPE I DIABETES
Required Forms
Required Supplies
Glucometer, Test Strips, Lancet, Alcohol Wipes, Insulin, Syringes, Fast Acting Carbohydrate, Glucagon
REQUIRED FORMS FOR MEDICATIONS AND CONCUSSIONS
REQUIRED FORMS FOR MEDICATIONS AND CONCUSSIONS
DAILY AND PRN MEDICATIONS
Required Forms
Physician Order for Medication
Required Supplies
Medication in Original Pharmacy Labeled Container
EPISODIC MEDICATIONS
(< 10 day course of treatment)Required Forms
Medication Permission Form or written note stating medication, dose, dates and time to be administered with parent/guardian signature
Required Supplies
Medication in Original Pharmacy Labeled Container
CONCUSSIONS
Required Forms
Acute Concussion Evaluation Care Plan
Must be completed and submitted upon initial evaluation, follow-up visits, and clearance to return to normal activity
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