It is our responsibility to help meet the medical needs of your child when he/she is in school.

We have various forms that will be required for certain situations.

Medical Consent Form: Required for all students.

School Health Record: Required for all students.

• Health History Update: Required for all students participating in sports teams.

• Athletic Physicals Form: Required for all students participating in sports teams.

Vision Form: For all students; to be completed by either your pediatrician or ophthalmologist.
(Not necessary if your pediatrician documented the values on the health record.)

• Asthma Form: Required for all asthmatic students; to be completed by the parent and physician.

Allergy Form: Required for all students with allergies requiring an Epi-pen or Benadryl. To be
completed by the parent and physician.

If your child is allergic to antibiotics, you can just note it on the health record.

• Consent for Delegate Administration of Epinephrine: For all students requiring an Epi-pen.

• Self-Administration Form: For students requiring medication on school trips (excluding Epi-pens);
to be completed by the parent and physician.

• Medication Administration Form: For special health care needs not addressed on the other
forms, such as eye drops, antibiotics, ADD and ADHD medications, etc.

Please note, at all times, medication whether prescription or OTC (over the counter) requires a physician’s order.