For printable copies , please click links below:
If your child has had any change in medical concerns since last year, you will need to complete the Health History Update Form. After completion you may print and send in to school, or scan and email it back to your child's school nurse. A paper copy can be provided if needed, please notify the school if so.
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Asthma Action Treatment Plan - (Required for all students with a diagnosis of asthma. No other medication forms need to be completed)
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Food Allergy Emergency Care Plan
(Required for all students that have a food allergy. Please also complete the Admin. of Epinephrine Authorization form.) |
Administration of Epinephrine Authorization
(Required for every student that has an order for use of Epinephrine) |
Medication Dispensing Form - (Required for all prescription and over the counter medications and treatments. Please see forms above for those medications associated with Asthma and Food Allergies).
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Guidelines for medication administration in school -(Please read over this general information regarding ALL medications in school.)
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Diabetes Medical Management Plan (DMMP) - Students with Diabetes must have a DMMP completed by their physician and the Parent/Guardian NJ Authorization for Care & Services and Sharing of Information form.
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NJ Authorizations for Care & Services and Sharing of Information - Parent/Guardian must authorize and return this document for permission for care of students with Diabetes.
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Food Allergy Questionnaire for Parents to Complete - Please complete this form if your child has a food allergy. We need to know if any special precautions are needed, including sitting separately from students eating the allergens your child is allergic to, whether an EPI PEN is required at home for emergencies, if your child is contact reactive, etc.