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Medical Forms

Medical Forms

Medication Authorization Form

This form is to be completed by the student's physician and parent for ANY medication to be administered at school.

Permission Form for Student to Self-Administer Emergency Medication

This form allows students, with parent permission, to self-administer emergency medication. JHCD FORM-3 must accompany this form.

Diabetes Management Plan

Diabetes Management Plan - Spanish

School Nurse Health Information - English

Parents should complete this form each year to provide the school nurse with the most up to date health information on thier student.

School Nurse Health Information - Spanish

School Nurse Health Information - Vietnamese

School Nurse Health Information - French

Multiple Vaccine Consent Form

Multiple Vaccine Consent Form - Spanish

Multiple Vaccine Consent Form - TDAP & Meningococcal

Multiple Vaccine Consent Form - TDAP & Meningococcal - Spanish

Physician Statement for Students Requiring Special Meals

Physical Form - NOT TO BE USED FOR RHS SPORTS PHYSICALS

This form may be taken to your physician when your child has a physical. Return the completed form to your school nurse.