Allergies & Anaphylaxis

Asthma

Diabetes

  • 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 NDEP 12.20.16.pdf 144.96 KB (Last Modified on January 10, 2017)
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Epi Pen Administration

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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Seizures

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