School Nurse » Medical Concerns

Medical Concerns

Medical Concerns

Please review this section and complete the appropriate documents needed in order to ensure that all health concerns are dealt with accordingly. If you have any questions please feel free to contact our health office.

Medication Administration Permission

If your child needs to take medication daily or occasionally during the school year, please have your doctor complete the form below.


All medication administration, including over the counter medication requires this form to be completed by your child’s doctor. A parent must also sign the form.


  •     Medication must be brought to the nurse by a parent.
  •     All medication should be in the original pharmacy container.
  •     No morning or late day medication will be given.
  •     Only medications required for life threatening emergencies will be given on a field trip.
  •     Your doctor may suggest that asthma inhaler and epipens be carried by students in their backpacks for immediate use when needed, please reach out to our health office if this is the case. 

Allergy Action Plan 

If your child is prescribed an epinephrine auto-injector for allergy, please have your doctor complete this form. Your doctor may also complete the portion of this form for self-administration of both the epinephrine and an antihistamine if he/she feels your child is able to self-administer. This form must also be signed by a parent.

Asthma Action Plan

If your child has a history of asthma, uses an inhaler or a nebulizer, please have your physician complete the asthma action plan. Your doctor should also complete the self-administration portion of this form if he/she feels your child is able to self-administer the medication.

Seizure Action Plan

If your child has a history of epilepsy or seizures, uses rescue medications for seizures, please have your physician complete the seizure action plan.

Permission to Share Information Form

If your child has any medical issues that may impact him/her in the classroom, this form gives me permission to share pertinent medical information with other school personnel. This is to protect the health and safety of your child.

Note to Parents

More forms are listed below. If your child has a diagnosis other than the ones that are above, please reach out so that the proper paperwork could be given to you.