Student Health Forms

Annual Student Emergency and Medical Information Form (S-865)

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.