The Annual Student Emergency and Medical Information form must be filled out every year by parents or guardians to allow the school nurse to medicate their child with Acetaminophen or Ibuprofen as prescribed by the School District’s medical Officer/pediatrician. Nurses cannot administer this medication without parental permission.
This form also gathers information about a child’s health history. This history can be vital in case of emergency or should the need for any type of medical treatment arise while a child is in school.
Student Health Forms
Annual Student Emergency and Medical Information Form (S-865)
Commonly Requested Forms
- Student Mask Accommodation Form
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- Med 1-Medication Form (PDF)
- MEH1-Report-of-Physical-Examination-Form (PDF)
- SEC-137A Physician’s referral for homebound instruction (PDF)
- M-152A Medical transportation request- Physician certification (PDF)
- Self-Medication Assessment Tool (PDF)
- S-865 Student Emergency /Medical Information (PDF)
- Medication / Equipment Received in School (PDF)
- MEH-155-Report of Private Dental Examination