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Health Care Plans

Health Care Plans and Transportation Bus forms must be submitted annually. Please print and return to the School Nurse. All Health Care Plans require a parent and Healthcare Provider's signature

Allergy Health Care Plan
- Allergy & Anaphylaxis Emergency Action Plan
- Epinephrine Authorization Form
Asthma Health Care Plan
- Asthma Medication Authorization Form
- Asthma Action Plan
Concussion Management Plan
- Concussion Management Plan: TMJH & PCHS
- K-7: ACE Plan
Diabetes Health Care Plan
Generic Health Care Plan
- Individual Health Care Plan/Emergency Action Plan
G-Tube Feeding Order
- G-Tube Request for Physician Feeding Safety Orders
Headache/Migraine Health Care Plan
- Headache/Migraine Emergency Care Plan
Lunchroom Accommodations
- Medical Statement to Recommend Special Meals, Accommodations, and Milk Substitute
Medical Release Form
- Medical Release Form
Medication Administration Authorization
- Health Plan: Medication Permission Form
- PCSD Formulario De Autorizacion A Adminstrar Medicinas
Seizure Health Care Plan
- Seizure IHP/ECP
- Seizure Medication Management Order (SMMO)
Sports Physical
- Sports Physical Form
Transportation