Emergency Plans of Care

Allergy Action Plan
          Form utilized to direct school personel actions to take in the event of an emergency related to condition.

Asthma Action Plan

          Form utilized to direct school personel actions to take in the event of an emergency related to condition.

Diabetes Action Plan

          Form utilized to direct school personel actions to take in the event of an emergency related to condition.

Generic Action Plan
         Form utilized to direct school personel actions to take in the event of an emergency related to condition.

Seizure Action Plan
        Form utilized to direct school personel actions to take in the event of an emergency related to condition.

Medication Administration Documents

Medication Consent Form
        Form for Medication to be given during school hours, must be completed by physician and authorized by parent.

Release Form

Consent for Release of Information

        Form to authorize release of protected health information to enhance academic success of student.

Return to Learn Documents

RTL Guidelines

RTL Academic Accommodations

RTL Concussion Protocol Parent Information

RTL Concussion Signs/Symptoms Checklist

RTL Post Concussion Sympton Checklist

RTL Parent Information Brochure

School Nurse Encounter Forms (School Nurse Only)

School Nurse Encounter Form (School Nurse Use Only)

School Nurse Record (School Nurse Use Only)

Student Services Referral Form (School Use Only)

Return to School Nurse Home Page