Student Health Services » Health Forms, Documents, Information

Health Forms, Documents, Information

Allergy and Anaphylaxis Plan

We are pleased to inform you that San Diego County now has a standardized Allergy and Anaphylaxis Emergency Plan (AAEP) that all schools and medical practices are encouraged to adopt. This plan is based on the published version endorsed by the American Academy of Pediatrics and was approved by the Coalition for Food Allergy in San Diego County Schools. The Coalition is made up of school nurses, allergists, pediatricians, and parents.

Chronic Illness vs COVID form

Some students may have medical conditions with symptoms which may mimic Covid. If so, please have the student’s healthcare provider fill out the Chronic Illness vs Covid form.

Health Forms: New forms required for each school year or when a medical condition changes

Authorization for medication administration:
This form is required for any medication, over the counter or prescription.

This form must be signed by a physician and must be renewed each school year. A doctor of chiropractor is NOT acceptable.

Diabetes medical management plan:
Regardless of a student’s independence with their Diabetes, students will still need written orders on file in the health office in case of an emergency. The orders must also include an order for Glucagon.

Specialized health care services (parent request prescriber order/request):
This form is used for two purposes. The first purpose is for students that are in our Special Education classes and who require assistance with activities of daily living.  The second purpose is for students that are not enrolled in special education however, need assistance with anything on an ongoing basis that does not otherwise have its own form.  Examples include: scoliosis braces or bathroom assistance during a broken appendage. A new form is completed each year.

Release of Information:
This form is needed when a member of the school will need to contact the physician for many different reasons. A couple of reasons include: correcting errors within physician’s orders in a timely manner or discussing certain procedures that are unclear in physician’s orders. This is very helpful for nurses when parents are having difficulty contacting their child’s provider.
Developmental and Health History / Antecedentes de Salud y Desarrollo: This form is used for student’s that need to complete a recent health history for a triennial IEP or if the student has had a change in their health condtion. English and Spanish

This is a generalized form and is used for any condition that we do not have a form already created for. Meaning, conditions other than: seizures, asthma, G tube feeding, or bee allergies. Examples of children who may need a medical management form: migraines, heart conditions, menstrual cramps, anxiety, fainting, high blood pressure. These forms may also be used in combination with someone that requires a special medication and further guidance for the health staff would be helpful.

If your child has a condition, please have the provider complete this form.

If your child does not have a health condition, and you received this form, please write” my child does not have a current health condition that requires attention while at school” and sign/date.

This form is needed to better manage the symptoms of an attack.

This form must be completed by a physician. This form should be updated each year or when your child’s asthma care changes.

If you do not see a form listed here or in the forms section, please email Margaret McLean: [email protected] to obtain the correct form.


Medi-Cal Billing Information Letters

Information regarding California health care for all children:

  • All In: Health Care for All Families
  • IMM-231 California Immunization Requirements Changes effective beginning in the 2019-20 school year.
  •  Influenza-like Illness
  • Parent’s Guide to  MRSA
  • What is  Enterovirus D68?

Info for Students

  • All In:  Health Care for All Families
  • IMM-231 California Immunization Requirements Changes effective beginning in the 2019-20 school year.
  • Influenza-like Illnesses
  • Neighborhood Health Care: Services and presentations on pregnancy prevention, preventive healthcare, medical screenings, HIV/STD education and prevention, guide to healthy relationships, and abstinence.
  • Preventing Youth Suicide