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Medical Forms

Forms to take to your child’s doctor, an emergency or urgent care, or other provider.

Please take the following school health forms with you any time you take your child to see a healthcare provider.  

  • Your Child’s Shot Record
    • Our school uses the School Module. However, because healthcare providers can get behind in uploading their immunization data to the state, it is always helpful to bring a copy of updated shot records to the school nurse after any visit where shots were given.
  • Medication Order
    • No medication can be carried, given, or taken while at school without a doctor’s order. This includes:  medication for a chronic condition like asthma or diabetes; medication for an acute condition, like strep throat or an ear infection, even though only needed for a few days; and all over-the-counter remedies.  The order must be filled out and signed by both the healthcare provider and the parent or guardian each year and each time a new medication is needed while at school.
  • Diet Order
    • If your child has food allergies, a disability, or a digestive condition requiring special dietary accommodations while at school, a diet order signed by a healthcare provider who has prescriptive authority must be on file at the school and updated yearly.
  • Forms for Sports Participation
  • ER visits
    • If for any reason your child goes to the hospital for illness or injury, hospital staff will usually ask if you need a note for school when you are discharged from the hospital. Please say yes, as it lets school staff know that your child has been medically cleared to return to school.  The note may also include instructions about activity restrictions that should be followed during the healing process.