Medication Forms

Allergy Form - Please fill out this form if your child has an allergy to food, insects, latex or the environment that may require medical intervention while at school. Antihistamines such as Benadryl are frequently brought to school to manage allergies. Students who have severe reactions must have an epipen at school at all times.

If your child has a severe allergy, please contact me (867-8840) so that we can establish a plan of care for school.

Asthma Form - Please complete this form if your child has asthma. If your child has severe asthma, please contact me (867-8840) so we can establish a plan of care for school.

Diabetic Care Plan - Please complete this form if your child has diabetes and then contact me (867-8840) so we can establish a plan of care for school. 

Medication Consent Form and Medication Record- This form must accompany both prescription and over-the-counter medication. Both parent/guardian and physician must sign the Medication Administration Consent From for administration of any prescription medication during the school day. For over-the-counter (non-prescription) medication to be administered during the school day, only the parent/guardian signature is required. The medication record form is used for recording of administration of medication.