Health Forms

New Medical Action Plans (MAPs) are required every school year for medical treatment at school. Please note the following:

  • A new physical form must be filled out every year. A current year physical is one given on or after April 15th of the previous school year

  • If epinephrine is ordered for emergency use at school, complete the MAP for Severe Allergy.

  • If your child's food allergy is not potentially life-threatening and only an antihistamine is desired (such as Benadryl), then Form A for prescribed medication must be used so school staff has a doctor's order and directions.

  • If medication is to be given at school routinely but is not part of a MAP order, such as Ritalin for ADHD, then Form A for prescribed medication must be filled out.

  • For diabetes, please use the health care plan and orders your child's physician prefers.

  • Over the counter medication ordered by the parent alone are intended for occasional use only and should follow the guidelines on the reverse side of that form- Form C.

  • All medication must be in the original container or pharmacy prescription bottle labeled with the student's name, medication name, dosage, and frequency to dispense instructions.

Please return the MAP to the office of the school location of which your student is attending.

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