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Emergency Care Form

2023-2024_ECF_Rev_09-23.pdf 176.39 KB (Last Modified on September 20, 2023)

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Anaphylactic Allergy Action Plan

AllergyAction_09-2023.pdf 109.73 KB (Last Modified on September 20, 2023)

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Asthma Action Plan

Student_Asthma_Action_Plan.pdf 187.9 KB (Last Modified on September 20, 2023)

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Diabetic Care Plan (All Ages)

DiabeticCarePlan_ALL_AGES_Rev_09-23.pdf 179.48 KB (Last Modified on September 20, 2023)

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Medical Plan of Care for School Food Service

Medical_Plan_Dietary_June 2022.pdf 711.42 KB (Last Modified on July 7, 2023)

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Rescue Medication Access Permission Form

Rescue_Med_Access_Perm_Form Rev 09-2023.pdf 145.29 KB (Last Modified on September 20, 2023)

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Consent For Medication Administration And Medication Order Form

Consent_For_Med_Admin_Med_Order_Form_09-2023.pdf 86.53 KB (Last Modified on September 20, 2023)

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Diastat - Seizure Action Plan

Diastat_Seizure_Action-Plan_rev_09-23.pdf 121.8 KB (Last Modified on September 20, 2023)

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Seizure Action Plan

Seizure_Action_Plan_rev_09-2023.pdf 118.45 KB (Last Modified on September 20, 2023)

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Private Physical Examination Form

Private or School Physical Examination, PA Dept. of Health H511.336 (rev. 9/2012)

Physical Examine Form_New.pdf 223.89 KB (Last Modified on March 4, 2013)

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Private Dentist Report (H514.027 02-2023) And Low-Cost Dental Clinics

PA_State_Dental_Form-W-Low-Cost_Dental_Clinics_09-2023.pdf 634.41 KB (Last Modified on September 20, 2023)

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Homebound Instruction Request

HB_Request_Rev_09-2023.pdf 192.45 KB (Last Modified on September 20, 2023)

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Homebound Instruction Extension Request

NOTE: To be used by students currently receiving homebound instruction within the same school year.

HB_Ext_Req_Rev_09-2023.pdf 182.77 KB (Last Modified on September 20, 2023)

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Transportation Request For Medical Reasons

Med Transpo Request_Rev_09-2023.pdf 171.06 KB (Last Modified on September 20, 2023)

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Extension Request For Medical Transportation

Note: To be used by a student currently receiving medical transportation within the same school year.

Med_Transpo_Ext_Request_09-2023.pdf 157.62 KB (Last Modified on September 20, 2023)

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