Health Information
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School
Nurse's Immunization Letter 
The school nurse details
the immunization requirements
Medical
Examination and Immunization Record
Use this form for the
medical examination of student by a private physician and for immunization information.
School
Nurse's Medication Letter
The school nurse details
the administration of prescription and/or
over-the-counter medications.
Parental Permission for First Aid, Screenings, Medications and Release of Medical Information
Use this form to give the
school nurse permission to administer medication.
Helpful Information on Food Allergies
Use this form to help the office and your child's teacher better understand your child’s food allergies and what precautions and treatments should be followed
Emergency
Health Plan for Anaphylaxis
Use this form to authorize permission for emergency
treatment due to allergies.
School's Policy on Epinephrine Administration
Use this form to be informed of the school's policy on epinephrine administration.
Self-Administration of Medication
Use this form to authorize your child to self-administer his/her medication.
Diocesan Waiver/Consent Form to Designate the School Nurse to Administer Medications
Use this form to designate the school nurse (or Designee(s)) to administer medication.
School
Nurse's Asthma Letter
The school nurse provides information on the Asthma
Action Plan.
Asthma
Action Plan
Complete this form if your child has any type of
Asthma or Reactive Airway Disease.
Emergency
Information
Use this form for
emergency contact information.
Annual Athletic Pre-Participation Physical Examination Form
Use this form for the
medical examination of student by a private physician prior to participating in any ATHLETIC event
Health History Form
Checklist of medical concerns - form must be in on the 1st day of school
Helpful Information Concerning Your Child’s Insect or Bee Sting Allergy
Use this form to help the office and your child's teacher better understand what precautions and treatments may be necessary if your child has a reaction
Authorization to Administer Over-the-Counter Medications
Use this form to give the
school nurse permission to administer a throat soother
or Tums.