Clinic Forms
CLINIC CARD
MEDICATIONS:
Authorization to Carry Over The Counter Medication (in English)
Authorization to Carry Over The Counter Medication (in Spanish)
Authorization to Carry Prescription Medication (in English)
Authorization to Carry Prescription Medication (in Spanish)
ASTHMA:
Asthma Care Plan
Asthma Care Plan (Spanish)
Kellen Edwin Bolden Act
Authorization to Carry Prescription Medication
Release of Medical Information
DIABETES:
Diabetes Medical Management Plan
Authorization to Carry Prescription Medication
Diabetic Supply Sheet
Insulin Information Sheet
SEIZURES:
Seizure Action Plan
Seizure Action Plan in Spanish
Doctor’s Orders For Emergency Seizure Medication (including, but not limited to Diazepam, Diastat, Midazolam, and Versed)
Release of Medical Information
ALLERGIES:
Food Allergy & Anaphylaxis Action Plan
Food Allergy & Anaphylaxis Action Plan (en Espanol)
Authorization to Carry Prescription Medication
Release of Medical Information
SICKLE CELL:
Sickle Cell Care Plan