Forms

Please print out these forms and bring these to me if your children have any of the following needs:

I will need these forms BEFORE the start of the NEW school year.

If your child has a food or any type of allergy that requires an Epi Pen:

**If your child has a food allergy, this form needs to be filled out before the first day of school so I can inform Mrs. Moy/Food Services for special dietary arrangements**

Please fill out and return these forms for students with Epi Pens / Severe Allergies:

If your child/children have asthma and will need to keep an inhaler at school (even if student is self-carry), please have the doctor fill out these forms and bring back to me with the inhaler and/or nebulizer:

If you would like to leave over the counter medication with me over the year to give to your child/children, please have these forms signed by your doctor before schools starts and bring with your unopened medication when you come see me:

2023-2024 Medication Administration Request Form

If your child/children have known seizures, please have these forms signed by the doctor and bring back to me with the as needed prescription medication for seizures:

If your child/children have diabetes, please have these forms signed and filled out by the doctor and brought back to me with the glucometer and prescription insulin:

If your child/children will need daily medication administered at school, please have the following forms signed and filled out by the doctor and brought back to me with the needed prescription medication:

2023-2024 Medication Administration Request Form