Health Forms

Medications will be given during school hours when absolutely necessary. We encourage dosage schedules which allow medicine to be taken before and after school. When this is not possible, health services personnel will follow the guidelines below when administering medication to your child at school. If your child will need special assistance or additional monitoring to take their medication at school, please contact the health services staff to discuss this.

English: Permission for Student to Carry and Self-Administer Prescribed Asthma Medication (PDF)
Spanish: Permiso para que el estudiante lleve y autoadministre medicamentos recetados para el asma (PDF)
Arabic: إذن للطالب بحمل أدوية الربو الموصوفة وإدارتها ذاتيًا (PDF)
Amharic: የተማሪ የታዘዘ የአስም መድሃኒት እንዲወስድ እና እራሱን እንዲያስተዳድር ፈቃድ (PDF)
Somali: Ogolaanshaha Ardayga inuu Qaado oo is-maamulo Daawaynta Neefta ee loo Qoray (PDF)

English: Permission for Student to Provide Self-Care for Diabetes (PDF)
Spanish: Permiso para que el estudiante proporcione autocuidado para la diabetes (PDF)
Arabic: ذن للطالب لتقديم الرعاية الذاتية لمرض السكري (PDF)
Amharic: ለተማሪው ለስኳር በሽታ እራስን መንከባከብን እንዲያቀርብ ፍቃድ (PDF)
Somali: Ogolaanshaha Ardayga inuu Bixiyo Is-daryeelka Sonkorowga (PDF)

English: Medication Guidelines and Authorization Form - Elementary (PDF)
Spanish: Directrices de medicamentos y formulario de autorización - Primaria (PDF)
Arabic: إرشادات الدواء ونموذج التفويض - ابتدائي (PDF)
Amharic: የመድሃኒት መመሪያዎች እና የፈቃድ ቅፅ - የመጀመሪያ ደረጃ (PDF)
Somali: Tilmaamaha Dawooyinka iyo Foomka Ogolaanshaha - Dugsiga Hoose (PDF)

English: Medication Guidelines and Authorization Form - Secondary (PDF)
Spanish: Directrices de medicamentos y formulario de autorización - Secundaria (PDF)
Arabic: إرشادات الدواء ونموذج التفويض - ثانوي (PDF)
Amharic: የመድሃኒት መመሪያዎች እና የፈቃድ ቅፅ - ሁለተኛ ደረጃ (PDF)
Somali: Tilmaamaha Daawaynta iyo Foomka Ogolaanshaha - Dugsiga Sare (PDF)

Any child with severe, life-threatening allergies requiring the use of an epinephrine pen, or epi-pen, will have a food allergy action plan or an emergency action plan. This plan will include specifics regarding when the pen is to be used and who is to be called in case of emergency.

English: Food Allergy & Anaphylaxis Emergency Care Plan (PDF)
Spanish: Plan de Atención de Emergencias de Alergias Alimentarias y Anafilaxia (PDF)
Arabic: خطة الرعاية الطارئة لحساسية الطعام والتأق (PDF)
Amharic: የምግብ አለርጂ እና አናፊላክሲስ የአደጋ ጊዜ እንክብካቤ እቅድ (PDF)
Somali: Xasaasiyadda Cuntada & Qorshaha Daryeelka Degdegga ah ee Anaphylaxis (PDF)

English: Permission for Student to Carry and Self-Administer Prescribed Epinephrine (PDF)
Spanish: Permiso para que el estudiante lleve consigo y se autoadministre la epinefrina recetada (PDF)
Arabic: إذن للطالب بحمل الإبينفرين الموصوف وإدارته الذاتية (PDF)
Amharic: የተማሪ የታዘዘ ኢፒንፍሪን እንዲሸከም እና እራሱን እንዲያስተዳድር ፈቃድ (PDF)
Somali: Ogolaanshaha Ardayga inuu qaado oo is-maamulo Epinephrine la qoray (PDF)

English: Medical Statement for Student Requiring Meal Modification (PDF)
Spanish: Declaración médica del estudiante que requiere modificación de comidas (PDF)
Arabic: بيان طبي للطالب الذي يطلب تعديل الوجبة (PDF)
Amharic: የምግብ ማሻሻያ ለሚፈልግ ተማሪ የህክምና መግለጫ (PDF)
Somali: Bayaanka Caafimaadka ee Ardayga u Baahan Wax ka beddelka Cunnada (PDF)

Parents can purchase additional insurance protection for accidents that occur during school classes, while students are away from school, at home, during the weekends, and vacation periods, including summer months. The cost of this insurance is a one-time payment of $40.00.  For information regarding this optional coverage, contact KidGuard Insurance at 1-800-432-6915 or email a request for information to contact@kidguardinsurance.com.