If your child has a serious health concern, your school nurse will work with you, your child's physician, and teachers to have a plan in place in case of a life threatening medical emergency such as anaphylactic allergic reaction, asthma attack, diabetic emergencies, or seizures. The forms below will be completed by the physician and turned into the school nurse. In addition, a medication authorization form will need to be completed for any medications to be given at school including epi-pens, inhalers, and emergency seizure medications. If your child has any other health concerns please contact your school nurse to ensure a safe environment for your child to learn.

Allergy Emergency Action Plan

  • Must have a physician order to carry an epi-pen.

  • Epi-pen required to be stored in the nurse's office for emergencies.


allergy action plan general.pdf
Authorization for Medication Rev.doc

Asthma Emergency Action Plan

  • Must have a physician order to carry an inhaler.

  • Please also consider sending an inhaler to keep in the nurse's office for emergencies.


Asthma action plan.pdf
Authorization for Medication Rev.doc

Diabetic Emergency Action Plan

  • Physician order required for all medication including insulin and glucagon.

  • Extra supplies to be stored in nurse's office including emergency medications such as glucose tabs and glucagon.


DMMP.pdf
Authorization for Medication Rev.doc
TPS Diabetes Parent Letter.doc

Seizure Emergency Action Plan

  • Physician order required for emergency medications.

  • Emergency medication to be stored in nurse's office.


Seizure Action Plan.pdf
Authorization for Medication Rev.doc

Alexia Hickman, RN, BSN

600 Bassett street

Toledo Ohio 43611

(P) 419-671-6650

(F) 419-671-6695

ahickman1@tps.org


*I am here everyday from 8:30am-3:45pm, contact me with your questions or concerns anytime.*