Forms

Anaphlaxis Emergency Care Plan
Use this form to document a plan for your child in case of a severe allergic reaction.
Grade 6 to 12 Permission to Carry
This form needs to be filled out by the physician, parent and middle school nurse if your child will be self-carrying their inhaler and/or EpiPen. Students only in grades 6-12 have this option.
Over The Counter Medication Form
Parents may fill out this form if their child needs to have over the counter medications during the school day. Examples would be tylenol, ibuprofen, cough drops. Parents must supply the medication in the original bottle and students cannot transport medications. Adults must transport the medication.
Physician Medication Form
This form needs to be completed for any prescription medication that needs to be given during the school day. There must be a parent signature on the top portion as well as the physician signature on the bottom. All medication must be brought in the original pharmacy bottle and brought in by an adult. No student may transport medication.
Physician Physical Form
This form may be used by the physician for the physical exam. We also accept forms from the physician office.