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Forms

The following forms are available for download in the folder below. 

Anaphlaxis Emergency Care Plan

Use this form to document a plan for your child in case of a severe allergic reaction.


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.

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.

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 epi pen.  Students only in grades 6-12 have this option.

Physician Physical Form

This form may be used by the physician for the physical exam.  We also accept forms from the physician office.