Health Services Forms

Medication for a Short-Term Need

Use the Short-Term Medication Form when a medication is needed for a limited period of time due to a temporary illness, injury, or treatment.

Examples:

• Antibiotics prescribed for a specific number of days
• Temporary medications following an illness or procedure
• Other short-term treatments

Short-Term Medication Form - PDF

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Medication Needed Long-Term

Use the Long-Term Medication Form when medication will be needed on an ongoing basis or for an extended period of time and is not included in a Chronic Health Condition Action Plan.

Examples:

• Daily medication administered during the school day
• Scheduled treatments not associated with an action plan
• Ongoing medications requiring school support

Long-Term Medication Form - PDF
 

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Over-the-Counter (OTC) Medications

Over-the-counter (OTC) medications may be available for administration at school when parent/guardian authorization has been completed through the annual SchoolCare enrollment process.

The school district stocks select OTC medications that are available for students when needed. These medications are provided under standing orders established by the Health Services Medical Director and are administered by trained Health Services staff according to district procedures.

If you were unable to complete the electronic enrollment process in SchoolCare or did not provide authorization for OTC medications during annual enrollment and would like your student to have access to these medications at school, please complete the OTC Medication Form to provide authorization for administration during the school year.

The OTC medications available through the district standing orders include:

• acetaminophen (Tylenol)
• ibuprofen (Motrin/Advil)
• cetirizine (Zyrtec)
• calcium carbonate (Tums)

OTC Medication Authorization - PDF

Students who require ongoing health support at school may need a Chronic Health Condition Action Plan. These plans provide individualized instructions from the healthcare provider, including care needs, emergency response steps, and medication instructions when applicable.

Medication orders for chronic health conditions are included within the student’s action plan when applicable. A separate medication form may not be needed.

Examples:

• Asthma Action Plan - PDF
• Allergy/Anaphylaxis Action Plan - PDF
• Diabetes Medical Management Plan (pump) - PDF
• Diabetes Medical Management Plan (injection) - PDF
• Seizure Action Plan - PDF
• Enteral Feeding Care Plan - PDF
• Urinary Catheter Care Plan - PDF
• Tracheostomy Care Plan - PDF
• Other Nursing Care Plan - PDF

Some students may require meal accommodations due to a medical condition, food allergy, or other health-related need. Health Services works with families and healthcare providers to ensure the appropriate medical documentation is completed to support your student's needs during the school day.

Once the required documentation is completed and submitted, Nutrition Services will make every effort to provide the requested accommodations as outlined by the healthcare provider. Families should be aware that accommodations are based on the information provided on the medical documentation and available resources.

For more information about meal accommodations, required forms, and how to request support, please visit Nutrition Services: LINK

 

 

The annual SchoolCare enrollment process provides families the opportunity to update important health information for their student, including medical conditions, health concerns, emergency contacts, and other information that helps our Health Services team support your student during the school day.

If you were unable to complete the electronic enrollment process in SchoolCare or need to provide updated health information outside of the annual enrollment window, please complete the Health History Form and return it to your student’s school health office.

Keeping your student’s health information current helps our Health Services team understand your student’s needs, respond appropriately in the event of illness or injury, and provide the best possible support while your student is at school.

Health History Form - PDF