Used when a child has a history of severe allergies - includes food and drug allergies.

Required if child has been diagnosed with Asthama.  Provides a step-by-step plan of care for the child.

Required if child is diagnosed with diabetes.  Gives a step-by-step procedure for taking steps needed in event of hypoglycemia or hyperglycemia.

Complete this form to have any medication administered at school by school nurse or authorized personnel.  It must be signed by a physician.

To be completed by a physician.