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HEALTH FORMS

HEALTH FORMS

USED DISTRICTWIDE

Action Plans

Administration of Medication

Permission for Administration of Medication in School
Per District Policy 5330 & Regulation 5330, Permission slip for medication to be administered to students in school by the school physician, a certified or non-certified school nurse, a substitute school nurse employed by the district or the student's parent/guardian.

If medication is needed at school aside from those listed on the Asthma, Anaphylaxis or Seizure Action Plans, please complete the "Permission for Administration of Medication in School Form".
Permission for Self Administration of Medication in School
Per District Policy 5330 & Regulation 5330, District-wide form for permission for self-administration of medication for a potentially life-threatening illness.

For students 7 - 12, in addition to an action plan submitted (for Anaphylaxis, Asthma, and/or Seizures), please also include the "Permission for Self-Administration of Medication in School" for all inhalers and epipens. If unable to self-carry, please reach out to your building nurse. Note: Students who participate in school sports and clubs will need to be able to self-administer their emergency medication.

SCHOOL SPECIFIC

Gr. PK - 6 Physical Exam Forms for New Students

Elementary School Health History Form

Class Restrictions for Medical Reasons

Gr. 6 State-mandated Immunizations

Physical Exam Form

Medical Condition Update

Gr. 7 - 12 Sports

Minimal Immunization Requirements for School Attendance in NJ

Physical Education Restrictions for Medical Reasons

Gr. 8 Weight Room Use

Gr. 9 - 12 Medical Restrictions