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Health-Related Forms & Documents

Asthma Action Plan

AsthmaActionPlan.pdf 381.57 KB (Last Modified on April 25, 2022)

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Diabetes: Glucometer Testing

Glucometer Testing Letter.pdf 137.82 KB (Last Modified on April 25, 2022)

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Diabetes: Order and Care Plan

CI 13 Diabetes Order and Care Plan 9.2020_final.pdf 325.07 KB (Last Modified on April 25, 2022)

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Diet Order

CMS Diet Order 2024 updated.pdf 44.01 KB (Last Modified on December 9, 2024)

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Health Assessment Transmittal Form ENGLISH (ver2016)

HAForm2016.pdf 39 KB (Last Modified on April 25, 2022)

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Health Assessment Transmittal Form SPANISH (ver2016)

HATransmittalformParentSecSpanish.pdf 215.51 KB (Last Modified on April 25, 2022)

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Immunization Requirements (SPANISH)

NC School Vaccine Checklist SPA.jpg 1.47 MB (Last Modified on July 12, 2023)

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Medication and Self-carry Authorization Form

Med-01-Medication-Authorization-Forms-8.2024.pdf 312.67 KB (Last Modified on March 13, 2025)

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Seizures: Diastat MD Order

Diastat_MD_Order.pdf 234.69 KB (Last Modified on May 6, 2022)

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Seizures: Emergency Action Plan

CI-21-Seizure-EAP-and-Med.-Order8.29.2024.pdf 247.75 KB (Last Modified on March 13, 2025)

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Severe Allergy: CMS Diet Order

CI-24-Severe-Allergy-EAP-and-Medication-Order-8.2024.pdf 302.69 KB (Last Modified on March 13, 2025)

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Severe Allergy: Emergency Action Plan

CI-24-Severe-Allergy-EAP-and-Medication-Order-8.2024.pdf 302.69 KB (Last Modified on March 13, 2025)

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Sickle Cell: Emergency Action Plan

CI25SickleCellEAP7-09.pdf 96.13 KB (Last Modified on April 25, 2022)

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