Health Forms

Allergy Food Action Plan

This form must be completed and signed by the physician and parent/guardian if your child is required to use medication and/or Epinephrine Pen for severe allergic reactions to food.

FARE Food Allergy Action Plan June 2014.pdf 658.98 KB (Last Modified on June 16, 2014)

Allergy Plan for Severe Reactions to Non-Food Substances

This form must be completed and signed by the physician and parent/guardian if your child is required to use medication and/or Epinephrine Pen for severe allergic reactions to insect bites or substances other than foods.

Allergy form for severe reactions to non-food substances rev 4-13.pdf 249.32 KB (Last Modified on May 29, 2013

Asthma Action Plan

If your child uses an inhaler at any time during the school day or during school activities, this form must be filled out and signed by your physician. This is the only form accepted by the State of New Jersey. It is required each school year.

Asthma Action Plan 2013.pdf 756.59 KB (Last Modified on June 16, 2014)

History & Physical Form (Grades Pre-K - 5)

This form is used for elementary students. It includes a medical health

history and physical examination form

History - Physical Grades Pre K -5.pdf 242.98 KB (Last Modified on May 29, 2013)

Medication Authorization

If your child requires prescription or over-the-counter medication during the course of the school day,

this form must be completed by your physician and signed by the parent/guardian. Medications must be provided in the original package.

MedicationAuthorization.pdf 3.66 KB (Last Modified on May 29, 2013

Student Health History

All students that are new and/or transferring into our District need to complete this health history form.

Student_Health_History.pdf 222.31 KB (Last Modified on May 29, 2013)