Health Room Forms
Please click on the following links to download each health form:
If your child requires any medication, prescription or over-the-counter, during school hours a Medication Authorization form must be completed by your medical provider and signed by a parent/guardian each school year.
- Medication Authorization Form
- Physical Exam Form (195 KB) PDF
- Private Dental Exam.pdf
- Asthma Care Plan/Inhaler & Nebulizer Orders
- Sun Screen Parent Form
- Sun Screen Student Form
If your child has any medically necesitated dietary restrictions, such as food allergy, intolerances or restrictions your physician must complete the attached form each school year for the food services to provide an alternate meal item:
- Allergy and Anaphylaxis Emergency Plan*THIS FORM MUST BE COMPLETED FOR ALL EPINEPHRINE ORDERS.
- Medical Plan of Care for School Food Service (Milk intolerance/allergy) *Note this must be signed by a physician each school year.