Health Plan Forms

Health Plan Forms 

Medication required by a student shall not be administered at school, during regular school hours or during school-related activities, unless absolutely necessary to maintain the continued attendance of the student. This policy shall apply to both prescription and non-prescription medication. Refer to BOE Policy 7:270. The medication shall be brought to the school by the parent or guardian. Prescription medication must be in a pharmacy labeled container and include the student’s name, the name of the drug, dosage to be taken, name of the prescriber and date of the prescription. Medication improperly packaged or labeled will not be administered. A medication administration form must be completed and signed by the parent or guardian, as well as the student’s licensed healthcare provider (MD, APRN, PA).  Any unused medication will be returned to the parent or guardian. If the parent/guardian does not pick up the medication by the last day of school, it will be disposed of by the school nurse.  Inhalers and Epinephrine Auto-Injectors may be carried and self administered by the student with written authorization from the parent and medical provider. 

If your child has a medical diagnosis that needs management in the school setting, please refer to the forms below for the appropriate forms. Students with asthma must have an asthma action plan filled out. Students with allergies (food included) must have allergy forms filled out. Parents are responsible for providing all required supplies and medications to manage the condition at school. 
 
State law requires our school district to annually inform parents of students with life-threatening allergies or life-threatening chronic illnesses of the applicable provisions of Section 504 of the Rehabilitation Act of 1973 and other applicable federal statutes, state statutes, federal regulations and state rules. If your child has a life-threatening allergy or life-threatening chronic illness, please notify the building nurse at (847) 673-1141 x 1102. Federal law protects students from discrimination due to a disability that substantially limits a major life activity. If your student has a qualifying disability, an individualized Section 504 Plan will be developed and implemented to provide the needed support so that your student can access his or her education as effectively as students without disabilities. Not all students with life-threatening allergies and life-threatening chronic illnesses may be eligible under Section 504. Our school district also may be able to appropriately meet a student’s needs through other means.