• Clinic Title
  • Forms and Information

    • Some health conditions may require that additional documentation be kept on file at your local school. Please request the following forms from your student's school clinic. Families will receive the forms that pertain to your child and be asked to return them directly to your school.

      • Administration of Medication Request Form
      • Allergy Emergency Plan Form
      • Asthma Management Plan & Medication Form
      • Home Treatment Recommendations for Head Lice
      • Parent's Request and Authorization for Auto-Injectable Epinephrine Form
      • Reasons to Keep Your Child Home from School
      • Student Clinic Card Form

    For the safety of all students at our school, the following guidelines should be followed when requesting administration of medications at school:

    • Only those medications required during school hours should be administered at school.  Please check with your physician regarding the need for medications to be administered during school hours.  
    • All medications, both prescription and over-the-counter must be accompanied by a completed Administration of Medication Request form and brought to the school clinic by an adult. Students may not transport medications to school.
    • All medications must be in an original child-proof container.  Prescription medications must be in their labeled prescription bottle.  School staff will only administer medication according to the directions on the label. 
    • Any medications remaining at the end of the school year must be picked up or school staff will dispose of them.
    • Students may only carry medication as prescribed by law with the required documentation.  Please check with our school clinic worker if your child needs to carry emergency medications with them.

    Reasons to Keep Your Child Home from School