Please read the bottom of the form where it states that the completed form needs to be faxed or emailed to the Nutrition department.  Please do not FORGET to do this.  

This form requires the signatures of both your child's physician and the  parent/guardian.

If your child has a nut allergy, then you will need to sign this form stating that you "do" or "do not" want your child to sit at the Nut Free table. Understand that if you choose to have your child sit at the Nut Free table, they can only have a friend who has purchased lunch from the cafeteria to sit with them. 

This form is filled out by the parent and signed by the parent, NO physician signature required.   

This form requires the signature of the child's doctor and the parent/guardian. 

Any prescription medication that is going to be given at school needs this form filled out and signed by both the physician and the parent/guardian. This form is NOT required for Over the Counter (OTC) medications. 

This form is sent home with your child when they are going on a field trip. If your child is going to need medication administered during the field trip, it is the responsibility of the parent/guardian to give the  student's medication to the teacher/field trip leader with instructions on when and how the medication should be given.  Medication must be in the ORIGINAL PHARMACY BOTTLE WITH CURRENT DATE.  Over the counter medication must also be in the original container. 

The Nurse will give the teacher/field trip leader the Epi Pen and Antihistamine. All staff are trained on how and when to use anaphylactic medications.  Parent/Guardian signature required.

For any procedure being done at school: Catheterization, Tracheal Suctioning, Tube feeding etc... This form will need the signature of the child's physician and the parent/guardian. 

This form is signed by parent/guardian, dated, and then to the right of the signature please check whether "you will" or "will not" pick it up at the end of the school year.   All medications not picked up will be destroyed...Medications are not carried over from one year to the next.