Student Health Information & Forms
Student Health Concerns: General Information
Many students have health concerns which may need to be addressed or cared for at school. School Registered Nurse Consultants work with Health Care Providers and School Health Clerks to administer medications, treatments and provide care during the school day.
Health care plans (HCPs) are written by the School Registered Nurse Consultant for students who have health conditions for which the health office has specific procedures to follow such as medications, treatments, special directions for emergency care or special precautions.
All students who have diabetes, seizures, severe allergies or need to medications at school should have a HCP. Other disorders may also have specific precautions which would require a HCP. PLEASE contact the School Registered Nurse Consultant or Health Clerk at your student’s school if you have concerns about your child.
Not all students with health concerns require a specific HCP unless we have specific medications, treatments, or care that should be given at school.
Student Health: Forms
Medication at School
Medication administration at school requires authorization from a licensed healthcare provider (Physician, Advanced Practice Nurse or Physician’s Assistant) AND signed parent/guardian permission.
Medication must be provided by the parent/guardian in an individual pharmacy-labeled bottle for the student who is to receive it. Medication will be given as directed on the pharmacy label and according to healthcare providers’ specific orders.
Medications include all prescription or over the counter medication (all pills, syrups, injections, inhalers, epipens, creams, sprays, eye drops, cough drops, sunscreen, etc.). Medications may not be expired.
Medications will be given following state laws only. It is required that all medication (except for those approved for self-carry by the school nurse) be kept in the Health Office for the safety of all students.
MEDICATION AUTHORIZATION – ENGLISH (7/2022)
MEDICATION AUTHORIZATION – SPANISH (7/2022)
Physical Forms (To be completed by health care provider)
DISTRICT 6 PHYSICAL FORM – ENGLISH
DISTRICT 6 PHYSICAL FORM – SPANISH
Severe Allergies or Anaphylaxis
For the safety of all students with severe allergies, the health office requests a signed health care plan from your health care provider along with an antihistamine and/or Epipen for school use. In extreme cases, middle and high school students who have proficient knowledge of anaphylaxis may “self-carry” an Epipen with a signed health care plan from the healthcare provider, parent/guardian, and the approval of a school nurse. However, a second Epipen is requested to be stored in the health office.
Allergy and Anaphylaxis Action Plan and Medication Orders
CO ALLERGY/ANAPHYLAXIS CARE PLAN (3/2018)
Food Allergies and Special Dietary Needs
The Special Dietary Needs Documentation Form must be completed by a recognized medical authority and returned to the Kitchen Manager at the site your student attends in order for meal substitutions/accommodations to be evaluated and provided.
SPECIAL DIETARY NEEDS DOCUMENTATION FORM 8.1.2022
EXPLANATION OF REQUIREMENTS FOR SCHOOL MEAL MODIFICATION REQUESTS
Asthma
For the safety of all students with asthma, the health office requests a signed health care plan from your healthcare provider along with an inhaler for school use. Typically, middle and high school students who are proficient users of inhalers may “self-carry” their inhaler with a signed health care plan from a physician, advanced practice nurse or physician’s assistant, parent/guardian and approval of the school nurse. However, a second inhaler is requested to be stored in the health office.
CO STANDARDIZED ASTHMA ACTION PLAN (2/2021)
Release of Confidential Information
Releases of information allow appropriate school staff (typically school nurse, psychologist or administrators) to obtain mental and physical health related records as well as discuss health concerns, treatments and care while at school with student’s health care provider. Parent must sign and date any release of information and may revoke the release at any time.
Release of Information (Typically works for most providers, except The Children’s Hospital and North Range Behavioral Health)
DISTRICT 6 RELEASE OF INFORMATION – ENGLISH
DISTRICT 6 RELEASE OF INFORMATION – SPANISH
The Children’s Hospital
CHILDREN’S HOSPITAL RELEASE OF INFORMATION – ENGLISH
CHILDREN’S HOSPITAL RELEASE OF INFORMATION – SPANISH
North Range Behavioral Health
NORTH RANGE BEHAVIORAL HEALTH RELEASE OF INFORMATION – ENGLISH & SPANISH