2014 Influenza Vaccine Consent Form

Student Health Information Form

Formulario de Informacion de Salud

HIPPA/FERPA - Compliant Authorization for Exchange of Education & Health Information Form 

Allergy & Emergency Medication Plan Form

Medication Request Form
If it is necessary for your child to receive prescription medication during school hours, the medication request form must be completed. For prescription medication, a parent/guardian signature and the signature of the prescribing doctor is required. All prescription medications must be brought to school in the original pharmacy labeled container. Ask your local pharmacist for an extra labeled container for school use.

Student Self-Medication Request Form
If you wish for your child to have access to over-the-counter medications during the school year you must provide the medication in the original packaging. Please complete a student self-medication request form in order for your child to receive over-the-counter medications. Please complete a student self-medication request form, that is signed by your health care provider, if you wish to have your child carry their prescription medication with them. Most commonly these include Epi-pens, insulin, and Albuterol inhalers. Other prescription medications, like for migraines as an example, can be reviewed case by case by the school nurse. Any form of narcotic, sedative, certain anxiety products, and stimulant medications will be stored and locked in the school’s office and at any time students are NOT allowed to be in possession of these substances.

In the event that your child may need to be administered medications while in the school setting, outside of the school setting while participating in school athletics, field trips, and/or other extracurricular activities, then medication forms must be completed and filed with the school.

Please be advised that our schools do not maintain a supply of any of the following medications: contact solution, topical antibiotic creams, burn creams, Advil (Ibuprofen), Tylenol (Acetaminophen), chapstick, cough drops, gum and countless other over the counter products. If your child may be in need of any of these medications, then parents can complete medication forms available at the school and provide the school with a supply of the medication for their child’s use, if needed within the school setting.