This form provides the school nurse with important medical information regarding your child's health, any conditions they may have, and emergency contacts. Each student is required to have one on file.
Prescription Medication Authorization*
This form is needed if your child requires administration of prescription medication(s) during school hours. The form must be completed, signed by a physician, and submitted to the school nurse along with the prescribed medication(s).
NOTE: One form per medication
Non-Prescription Medication Authorization Form *
This form is for students who may require administration of over-the-counter medication(s) during school hours such as, Tylenol, Advil, Benadryl, etc... The form must be completed, signed by a physician, and submitted to the school nurse along with the medication(s).
Authorization to Carry Inhaler...etc. Form *
This form is for students who are required and/or responsible enough to carry and self-administer an inhaler, Epi-Pen, and/or Insulin. This form must be completed, signed by a physician, and submitted to the school nurse.
Attention Parents and Guardian Whose Scholar May Suffer From Asthma and/or Allergies:
Below are two important forms that should be on file for your scholar's health and safety. Please print the plan of your scholar's needs, have completed by your child's physician, and submitted to LPA.
Food Allergy & Anaphylaxis Emergency Care Plan *
*See parent instruction/responsibilities for medication below