IIf your student has a food allergy, this form must be completed by your physician and submitted with all other food allergy forms.

This form is required to be on file in the clinic for all students in grades 3-6 whose physician and parent have agreed that the student has the ability to self-carry and administer their inhaler during school hours.

This form must be kept on file in the clinic for all students with a seizure disorder who will require medication to be stored in the clinic during the school day. A parent/guardian and physician signature is required.

Students with food allergies must have this form on file in the clinic. It should be completed and signed by a parent/guardian.

An Asthma Action Plan must be kept on file in the clinic for all students with asthma who will need to keep asthma medication in the clinic. This form must be completed and signed by a physician.

 

Students in 3rd-6th grade may carry an inhaler and self-administer it while at school with parent and physician permission as indicated on the Asthma Action Plan. A "Student Agreement" must also be on file in the clinic if a student will be carrying their inhaler with them during the school day. Please refer to the Forms section of the clinic website for this form.