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Health Information Forms

(Wed Apr, 1 2015)

If your child has allergies and/or asthma, and may require an Epi-Pen, Auvi-Q, or an inhaler during school hours or at an extra-curricular event please have your physician/health care provider complete the appropriate form (s). Parent/Guardian sign where indicated and return completed forms and medication to the nurse.

PLEASE NOTE:  to print the form correctly , right mouse click over the link and select OPEN LINK IN NEW WINDOW.

 Allergy Action Plan   
 Asthma Treatment Plan   
 Request for Administration of Medication  If your child may require medication during school hours, please have your physician/health care provider complete the Request for Administration of Medication Form. Parent/Guardian sign where indicated and return completed form and medication to the nurse.