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    FORMS

    Please review "Medications At School" on the menu to the right.

    Which Form Do I Use?

    •  Food Allergy Packet - for severe food allergies requiring an epi pen  
    •  Parent Request for Administration of Medication - for ALL medications 
    •  Emergency Med Self Carry Agreement * - Child carry's & uses own rescue medication (i.e. Inhaler) 
    •  Physician Request for Specialized Services - treatments or procedures requiring equipment         
    •  Physician Recommendation For PE or Sports - for PE or recess restrictions 
    •  Temporary Medical Guardianship - leaving temporary medical care to someone in your absence 

     

    Emergency Medication Self-Carry Agreement Form (HB 1688 and HB 1) 

    Allows students to self administer emergency rescue medications while at school or  school functions with
    permission from parents, physicians and the school nurse.  A school Emergency Medication Self Carry
    Agreement Form must be completed by the parent and physician and be kept on file in the school nurse's
    office.  It must be updated each school year.   

     

    If you need assistance completing any of the above forms, please call the school nurse at (972) 350-4204.