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Health Forms

Instructions for Asthma & Allergy Care Plans and Medication Release Form

 1. Please use one medication permission form per medication.  For example, if your student needs Tylenol and Advil at school, you’ll need to print and complete a medication authorization (release) form for each medication.

 2. All medications, including over the counter, need parent and health care provider signature.

 3. A care plan or medication release form is good for one school year unless there are changes in the health condition.  Expired care plans or medication release forms cannot be accepted.

 4. All medications must be in their original packaging or with pharmacy label.  Expired medications cannot be accepted.

 5. It is very important to have a care plan (not a medication release) if your student has allergies or asthma.  There are instructions on the care plans for staff to follow, keeping your student safer. You DO NOT need medication release forms if you have a care plan for allergy or asthma.  The medications are included on the plan.

 6. Colorado law allows for students to self carry inhalers or epinephrine pens.  A care plan is still required and it must be noted on plan by health care provider that the student is capable of self-carrying their medication.  The student and parent will also need to sign a self carry contract. It’s recommended to have back up medications (inhalers, Benadryl, Epi-pens) in the health office if possible.

 For any questions please call:

 Lynn Griebel, - Health Assistant DCES303-838-4888 ext: 1206

 Laura Giovannucci - -Health Assistant FMS & PCHS303-838-4642  ext: 1607

 Jen Harrington, BSN, RN   School Nurse Consultant303-679-7707

Click here for Anaphylaxis Plan

Click here for Self Carry Asthma and Allergy

Click here for Nebulizer Treatment

Click here for Colorado School Asthma Care Plan

Click here for Medication Permission form

 

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