• Medication, Treatment, and Procedure Forms

    To have medication, treatments, or medical procedures provided during school hours or at any school activity, a medical order signed by the student's medical provider and parent is required.  Once the form is completed, it must be provided to the school nurse along with the medication(s) or medical equipment.  

    Authorization for Mutual Exchange of Health Information  (Spanish)

     Medication Authorization Form (click here for form)                                                                     Provides permission for medication to be administered at school. Students may be permitted to self carry with the permission of the school nurse.

    Asthma Management Form (click here for form)                                                                                    Provides permission for an inhaler to be kept at school with the ability to adjust dosing depending on severity or the presence of any triggers/activity.

    Treatment Order Form (click here for form)                                                                                            Reviews the student's medical condition as well as the care and/or procedures to be performed during the school day.

    Tube Feeding Order Form (click here for form)                                                                                                            Provides permission for tube feeding to occur during the school day and addresses the various needs and diet.

    Nutrition Order Form (click here for form in English or Spanish)                                                                                          Provides permission for a student to receive alterations to their diet due to severe allergy, difficulty chewing/swallowing, digestive condition, or disability requiring different nutritional needs.  This does not accommodate those with personal diet preferences.

  • Immunization Forms

    Certificate of Immunization Status (CIS Form) (click here for form in English or Spanish)     Provides proof of school-required immunizations and/or immunity.

    Certificate of Exemption  (COE Form) (click here for form in English or Spanish)                    Provides exemption from school-required immunizations.  Exemptions may be claimed for personal/philosophical, religious, or medical reasons.  However, measles, mumps, and rubella may not be exempted for personal/philosophical reasons.