Nurse's Office / Forms for Parents

Forms for Parents

Medication and Health Care Forms

Medication Administration Information

Medication Consent

Health Care Plan Forms

Allergy Anaphylaxis Form

Asthma Form

Diabetes Health Form

Other Health Conditions Form

Seizure Form

Formularios para el Plan de Salud

Plan de salud para alergias

Plan de atencion de salud para el asma

Plan de salud individual y de emergencias para la diabetes

Plan para transtornos de salud

Plan de salud para convulsiones

Health Procedure Forms

Diastat Procedure

Exemption Waiver Form

Parent Request for Exemption

Special Diet Request Form and Information

Process for Implementing Request

Special Diet Request Form

**ALL MEDICATION MUST BE BROUGHT TO SCHOOL BY AN ADULT.

EMS ��˾�� requires new Dr. orders/prescriptions every year for
Epi-pens, inhalers, and any medical treatments or medications required during school hours.

Basic first aid and health care that may include diabetes maintenance and other specialized healthcare procedures are available at our schools. It is the parent or guardian’s duty to arrange care for sick children promptly. An up-to-date health record, which includes immunizations, screening results, and other pertinent medical data, is maintained on each student. Each parent should keep the school and the registered nurse informed yearly about any special medical information that would be important should the student have a medical emergency that needs attention. To keep information updated, a Student Health Information Form should be completed by the parent/guardian each year. All current Health Service forms may be found on the Health Services webpage.

It is the parent/guardian’s responsibility to provide current telephone numbers where they or alternate adults can be reached.

Thank you.

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Prairie Vista Middle School

Nurse's Office

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