Forms: Health

Please work with your School Nurse to develop individual health care plans and emergency care plans for your student

Annual Notices

Medication Forms

  • One form per medication, please
  • The form(s) (with all necessary signatures) must be submitted to the school health office prior to medication coming to campus.
  • Forms are valid per the school year (including ESY)


California Education Code, Section 49423; 5 CCR 600 Prescribed medication may be administered by the school nurse or other designated trained school personnel only when the Superintendent or designee has received written statements from both a student's physician and parent/guardian

Board Policy 5141.21 The Governing Board recognizes that some students may need to take medication prescribed by a physician during the school day in order to be able to attend school. The Superintendent or designee shall develop processes for the administration of medication to such students by school personnel.

Forms & Information