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    Below is the paperwork for severe allergies requiring the use of an Epi-pen. 

    These completed forms will function as Doctor's Orders and allow me to treat your child's severe allergies.  These forms must be returned to the Health Office by an adult with all necessary medications.  The Health Office DOES NOT stock Epi-pens or Benadryl.  Do not send paperwork or medications in your child's backpack; all medications must be signed into the Health Office by an adult.

     

    To be completed by parents and returned to Health Office:

    Student Severe Allergy History

    Medication Permission Slip 23-24

     To be completed by MD and returned to Health Office:

     Anaphylaxis Emergency Plan

    Doctor's Order for Prescription Medication

    A Nut Free table is available in the cafeteria.  Please complete this form and return to the Nurse.  

    Nut Free Table in Cafeteria

    Special Diet Request

    Diet Accommodations 23-24