Medication Forms & Chronic Illness Action Plans
Medication Forms
If you would like medication to be given to your child during the school day, a permission slip signed by the parent/guardian must be on
file. Any prescribed medications must also have the prescribing providers signature. Please print and complete the appropriate form
below and return it to the front office. All medications administered to students must be provided to the school in the original container.
We do request that the first ever dose of a medication to be given at home so the student can be monitored for adverse effects.
Downloadable Forms
Medication to be Administered at School Form
Over the Counter Parent Permission Form
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If your child has a chronic health condition, we want to help them stay safe and healthy at school with a health action plan. This document
gives us guidance on the best care for your child. Please not, if your child requires medication for a chronic health condition, we need a health
action plan on file. Specific health action plans can be found below. Print out the appropriate plan and have your child’s doctor assist you in
completing it. If the condition you are looking for is not there, please reach out to the school nurse to create a plan together.
Health Action Plans
ADA Diabetes Medical Management Plan
Epilepsy Foundation Seizure Action Plan