Administrative Center 310 E. James St. • Barrington, IL 60010

Allergies & Anaphylaxis

Diabetes

  • Medical Treatment Form (For diabetes and other medical treatments)

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    Needs to be completed annually for blood glucose testing and ketone testing.
    TX_ORDER_Blank_Form.pdf, 12.06 KB (Last Modified on November 7, 2012 )
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  • Diabetes Medical Management Plan

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    This form needs to be complete annually by the parent and physician and returned to the school nurse before the beginning of school.
    dmmp.pdf, 396.29 KB (Last Modified on November 7, 2012 )
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Medication Request Forms

  • Request for the Self Administration of Asthma Reliever Medication

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    Complete this form annually.  Photocopy of perscription label should be attached when form is return to the school nurse.
    Asthma_Reliever_Self_Administration_Form_2011.pdf, 30.10 KB (Last Modified on November 7, 2012 )
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  • Request For Administration of Medication

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    For all prescription and over the counter medications with the exception of asthma reliever medication, complete this form annually and return to the school nurse.  This form must be signed by both physician and parent/guardian.
    Med_Req_Form_-_Rx_and_OTC.pdf, 35.39 KB (Last Modified on November 7, 2012 )
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Health Office