Printable Forms

Instructions for Medication Administration Forms

For students to receive any medication (including non-prescription medicine) during school hours - print and complete the "Medication Administration Form."

For students with asthma - print and complete the "Asthma Action Plan" form.

For students with life threatening allergies - print and complete the "Food Allergy and Anaphylaxis Emergency Plan" form AND the "Epipen Form."

For students with a convulsive disorder - print and complete the "Seizure Action Plan" form.

**All of these forms require signatures by the Health Care Provider as well as the parent/guardian.** If you have any questions, please call your child's school nurse. Thank you.



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