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Authorization Forms for Parents

The nurse’s office requests that parents provide information about their child's health every school year. If your child's health requires healthcare while at school, we encourage the parents to have these forms completed by their child’s health care provider and returned to the school nurse. This will help in forming a collaborative plan of care with the provider. Below are links to forms that can facilitate this process.

 

  • Authorization for Medication Administration – Printable form to bring to your healthcare provider. Note for users of Assistive Technolgy: this is not a parent-fillable form.  It should be printed as-is and brought to your child’s healthcare provider.  (Document can still be fully read with a screen reader.) 
  • Asthma Emergency Action Plan (External Website) 
  • Allergy Emergency Action Plan  – Note to users of Assistive Technology – only some fields are fillable by the parent.  Form should be printed and brought to your healthcare provider. 
  • UDCA Form 
  • Seizure Emergency Action Plan – Note to users of Assistive Technology – only some fields are fillable by the parent.  Form should be printed and brought to your healthcare provider. 
  • Migraine Action Plan – Note to users of Assistive Technology – only some fields are fillable by the parent.  Form should be printed and brought to your healthcare provider. 

 


Disclaimer

Nurse's Corner does not contain medical advice. The contents of this website, such as text, graphics, images and other material are intended for informational and educational purposes only and not for the purpose of rendering medical advice. The contents of this website are not intended to substitute for professional medical advice, diagnosis or treatment. Please consult your physician for personalized medical advice. Always seek the advice of a physician or other qualified healthcare provider with any questions regarding a medical condition.