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Medical Forms

Please refer to the following forms if your child requires medication to be kept/given at school. These forms should be completed by the parent/guardian as well as the private MD. All Medication Request forms will be cosigned by the district's medical doctor as well. 


These forms should be filled out by you AND your child's medical doctor if they require medication to be kept and given at school. Each medication requires a separate form. This may include daily medications or emergency medications such as epinephrine, albuterol etc.

Medication Administration Form


This form should be filled out if your child is administering their own medication; i.e. insulin, or keeping it on them at school, i.e. albuterol.

Self-Medication Administration Form


This form must be filled out by your child's medical doctor if your child has food allergies.

Food Allergy Action Plan


This form must be filled out by your child's medical doctor if your child has asthma.

Asthma Treatment Action Plan


This form must be completed/signed by the student's parent/guardian and private medical doctor for diabetes management at school.

Diabetes Medical Management Plan


This form must be filled out by your child's medical doctor if your child has seizures.

Seizure Action Plan