Learning Today, Leading Tomorrow
Health Service Forms
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Medication Administration Information Form
- Parent/Guardian required to read, initial, and sign the form
- Only one form needed for all medications
- Form 1 of 2
- Medication Administration Information Form- Spanish Copy
- El padre/tutor debe leer, rubricar y firmar el formulario
- Solo se necesita un formulario para todos los medicamentos.
- Formulario 1 de 2
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Permission to Administer Medications at School
- Parent/ Guardian required to read, fill out, and sign the form
- One form needed for each medication
- Form 2 of 2
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Permission to Administer Medications at School- Spanish Copy
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- El padre/tutor debe leer, completar y firmar el formulario.
- Se necesita un formulario por cada medicamento.
- Formulario 2 de 2
- Stock Medication - Parent/ Guardian Information and Consent Form_ Columbus School District
- Asthma Action Plan _ Columbus School District
- Allergy and Anaphylaxis Emergency Plan_ American Academy of Pediatrics
- Concussion Sign and Symptoms Checklist_ CDC Heads Up
- Diabetes Medical Management Plan_ American Diabetes Association
- Diabetes (Type 1) Action Plan_ Columbus School District
- Headache/ Migraine Action Plan_ Columbus School District
- Medical Statement for Special Dietary Needs_ Wisconsin Department of Public Instruction
- Medical Statement for Special Dietary Needs_ Wisconsin Department of Public Instruction- Spanish
- Seizure Action Plan_ Epilepsy Foundation