MEDICAL CONDITION FORMS

MEDICAL CONDITION FORMS (DIABETES, EPILEPSY, & ASTHMA)
Posted on 01/14/2025

Reports of Students with Medical Conditions

To promote the safety and well-being of students with prevalent medical conditions (Anaphylaxis, Asthma, Diabetes, and/or Epilepsy), parents and/or guardians are encouraged to confirm annually to the Principal or Principal's designate if a student's medical status has changed by completing and submitting appropriate forms.

Medical Conditions- Diabetes

To promote the safety and well-being of students with prevalent medical conditions – Diabetes, parents and/or guardians are encouraged to confirm annually to the Principal or Principal's designate the student's medical status by completing and submitting appropriate forms.

If your child has this medical condition please download the forms, fill them out and have your child return the signed forms to the main office.

Annual Parent Guardian Request and Consent for Diabetes Intervention.pdf

Individual Diabetes Plan of Care.pdf 

Medical Conditions- Asthma

To promote the safety and well-being of students with prevalent medical conditions – Asthma, parents and/or guardians are encouraged to confirm annually to the Principal or Principal's designate the student's medical status by completing and submitting appropriate forms.

Authorization for Administration of Medication for Asthma Parent Form Annual Completion .pdf

Individual Asthma Plan of Care.pdf 

Physician Authorization for Asthma Management – use only when condition is new or interventions have changed (1).pdf 

Medical Conditions- Anaphylaxis

To promote the safety and well-being of students with prevalent medical conditions – Anaphylaxis, parents and/or guardians are encouraged to confirm annually to the Principal or Principal's designate the student's medical status by completing and submitting appropriate forms.

Secondary - Annual Parent Guardian Request and Consent for Allergy Anaphylaxis Intervention.pdf

Secondary - Individual Allergy Anaphylaxis Plan of Care.pdf 

Secondary - Physician Authorization For Administration of Allergy Anaphylaxis Medication- use only when medication is initiated or changed.pdf 

Medical Conditions- Epilepsy

To promote the safety and well-being of students with prevalent medical conditions – Epilepsy, parents and/or guardians are encouraged to confirm annually to the Principal or Principal's designate the student's medical status by completing and submitting appropriate forms.

Annual Parent Guardian Request and Consent for Epilepsy Intervention.pdf

Individual Epilepsy Plan of Care.pdf 

Physician Authorization for Epilepsy Management - use only when condition is new or interventions have changed.pdf 

If your child takes the school bus and has a medical condition, please fill the form below out and email to transportation.

School Bus Transportation Emergency Action Plan Template.pdf

Once the forms have been completed you can submit them to the Main Office. Please feel free to forward any questions and/or concerns to the school administrative team. 

Thank you in advance for your cooperation.