Last modified: August 9, 2022

Medical/Health Forms

Allergy and Anaphylaxis

• Allergy and Anaphylaxis Emergency Action Plan

Asthma

• Asthma AP  – English
• Asthma IHP – Spanish

Diabetes

• Diabetes Individualized Healthcare Plan
• Diabetes Emergency Action Plan
• Continuous Glucose Monitor Addendum
• Diabetes Medication Management Orders

Maturation

• Maturation Consent Form
• Maturation Consent Form Spanish

Medications

• Medication Authorization Form

Seizures

• Seizure Action Plan
• Seizure Medication Management Order

Vision Screening

• Vision Screening Opt-out Form
• Vision Screening Referral Form
• Vision Symptoms Questionnaire

Miscellaneous Forms

• Medical Release Form
• Generic IHP EAP Form
• Student Health Information English
• Student Health Information Spanish
• Special Dietary Request Checklist