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2017-18 Emergency Care Form

2017-18_ECForm_8-17.pdf 177.21 KB (Last Modified on September 7, 2017)

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Anaphylactic Allergy Action Plan

AllergyAction Plan.pdf 89.79 KB (Last Modified on February 28, 2013)

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Asthma Action Plan

ASTHMA ACTION PLAN PPS_Oct2013.pdf 402.00 KB (Last Modified on December 4, 2013)

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Consent - Rescue Medication Form

2015-16 Rescue Medication Form.pdf 239.81 KB (Last Modified on July 31, 2015)

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Consent - Medication Administration & Doctor Order Form

2015-16_MedAdmn3_Consent_Doc_Orders.pdf 256.67 KB (Last Modified on July 31, 2015)

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Dental Examination Parent Letter (Updated)

Including: List of Free and Low Cost Dental Treatment Centers and Health Insurance for Children

Dental SHS325A-Update_2014.pdf 572.05 KB (Last Modified on July 21, 2014)

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Diabetic Care Plan (Child)

Child - Diabetic plan.pdf 70.29 KB (Last Modified on March 4, 2013)

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Diabetic Care Plan (Teen)

Teen - Diabetic Plan.pdf 88.39 KB (Last Modified on March 4, 2013)

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Homebound Instruction Request

HomeBound Req.pdf 157.20 KB (Last Modified on August 25, 2016)

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Homebound Instruction Extension Request

To be used to extend homebound instruction for students currently receiving this service

2014-15_HBExtenForm.pdf 241.55 KB (Last Modified on July 31, 2014)

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Medical Plan of Care for School Food Service

Form for students with disabilities and non-disabling special dietary needs

Medical Plan of Care for School Food Service.pdf 64.99 KB (Last Modified on August 20, 2014)

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Medical Transportation Request (rev. 6-2016)

2016-17_New_ Med Transpo Request.pdf 175.96 KB (Last Modified on August 23, 2016)

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Medical Transportation Extension Request

(To be used to extend current request only)

Med Transpo EXT-Form2.pdf 130.59 KB (Last Modified on July 29, 2013)

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Physical Examination Form (New)

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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Seizure Care Plan

2014-15_Seizure Care Plan_7_11.pdf 144.05 KB (Last Modified on July 21, 2014)

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Seizure Plan - Diastat

Diastat-seizureplan.pdf 42.68 KB (Last Modified on March 4, 2013)

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