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Which Form Do I Need to Submit?

Which form do I need to submit?

Please consult the chart below to determine which Health Services forms are required based on your student's health concern.  Simply click and print the form titles that you require.

Please note that ALL medications require written doctor's authorization.

Student's Health Concern
 
 
 
 
 Life Threating Allergy
 
 
 
 

Dispensing Medication
 
 
 
 

Treatment or Procedure Authorization

Allergies:
Non-Food

X

 

 

X
(if applicable)

 

 

Allergies:
Food

 

X

 

X
(if applicable)

 

 

Asthma

X

 

 

X
(if applicable)

 

 

Health Concern: Medicated During School Hours

 

 

 

X
REQUIRED

 

 

Health Concern: Not Medicated During School Hours

 

 

 

 

 

 

Diabetes

 

 

X

X
(or equivalent)

 

 

Seizure Disorder

 

 

 

X
(if applicable)

X

 

Medical Treatment or Procedure required during school hours

 

 

 

X
(if applicable)

 

X