• Seizure Health Forms

    • Health forms must be submitted every twelve months.
    • Please print your paperwork, fill out completely, and bring the completed and signed paperwork to the Health Aide at your student’s school.
    • All health forms require a parent signature, most forms require a Provider's signature as well. 
    • Medication must be delivered by the student's guardian and checked in with authorized staff.  Medication delivered by a student will not be accepted.
    • Each medication must have a pharmacy label.
    • Every student with a medical concern must have a bus form for field trips.


    The following form are ALL required:

    Seizure Individual Health Care Plan (This DOES NOT require a provider signature)

    Seizure Bus Form


    The following forms are REQUIRED for students with medications at school: 

    Seizure Medication Management Order  (This requires a guardian AND provider signature)

    Daily Medication Administration Sheet


    The following forms will be given to need-to-know staff:

    Seizure Observation Record